the painted band-aid box

Moving.

2010-05-31T15:49:00.002-04:00

I am leaving this little space of internet for a different location.

check me out at www.notanemergency.tumblr.com for random rambles and awesome photos and also www.shutterpunk35mmphotography.tumblr.com for all my roller derby greatness.

thanks for reading
and continue at my new and improved blogs.
Painter

2010-03-25T11:52:00.002-04:00

"I don't like you"
"Well, Sir. They don't like me either" I pointed to my partners and the police officers that were standing around me. Apparently, my patient did not like me because I represented everything he hated about The Socialist Healthcare Machine....and I was there to take him away to his "Obama Death Panel" This was not my only difficult patient of the night. They seemed to all try my patience. Either they wanted to argue with me. ie; "I'm not going with you...but what happened?" You hit your head on that wall "Well, I'm still not going with you, but can you tell me why I'm bleeding?" or we were told about the call in a fucked up way ie; "Medic, MVA at the corner of Ghetto and Dirt Streets...but stand-by there, possible shooting involved." 10-4, Stand by at the Corner of Ghetto and Dirt for the MVA with the shooting?? "That's affirmative, 10-12 for 90 (Stand by for police) to secure the scene." Um...so you want me to stand-by at the CORNER WHERE THE FUCKING GUNS ARE?? I DON'T THINK SO DISPATCHER. I want you to repeat back what you just told me and ask yourself if that made any goddamn sense to you. Then after this exchange we get cancelled by The Police only to be sent to an MVA at 432 Ghetto St. WHICH IS THE SAME CORNER THAT THE MVA WITH THE SHOOTING WAS. Can they not see the map? I call attention to this by saying 10-4 MVA corner of Ghetto and Dirt St. with a response of "Negative Medic the numerics are 432 Ghetto." At this point I threw my hands up and just asked if police were on scene...to which I get a nasty "Affirmative" I'm not the one being the dumbass here, so you can quit with the attitude. Seriously.

I'm just hoping to make in a couple more weeks. Then I get a short break from The City. I will be going out to The Islands for a bit. "I need a rest" or so I was told. WHatever, if they think I need a rest, so be it. I'll go out there for a little and get paid to watch NCIS reruns and sleep.

2010-02-22T05:41:00.003-05:00

Okay, seriously. I'm sitting here at a quarter to six in the morning tapping out a post in the front of an ambulance on an iPhone, mostly because I want to get up on my soapbox for two reasons.
Reason #1 Full Arrests should have an age limit.
There is no goddamn good reason to put 98 year old granny on an AutoPulse machine, shove ET tubes down her throat and drill fucking holes in her tibia. NO FUCKING REASON! Let me say it again, NO FUCKING REASON! There is atime and a place to work like hell to save a life and there is a time to let go and let them die with dignity and peace. That means not with a bunch od paramedics and firefighter pumping and blowing, desicrating the hell out of a corpse. So say your goodbyes and let your elderly go.
Okay
Reason #2 Consolidated Dispatch.
Fuck off.
This shit isn't working, bitches. You are not sending the closest units and apparently have no idea even where your units even are. I do not sit at my station all the time, mostly because I am a social creature. I like to talk, socialize with my other street walkers. I either am sitting at the hospital chatting with the staff or I'm sitting on some street corner with the cops, shooting the shit with them... Because really what else am I going to do? Watch reruns of Law and Order on TNT? When I'm sitting in my district, 10-8, don;t sent another unit to a non emergent bullshit call just because they are four damn feet closer. They are getting supplies or writting a report or whatever. It's my district, let me handle it. Unless it is a dying baby or someone trapped under a building and those four feet are gonna matter for whatever reason, let them finish whatever they are doing because it is much more pressing than that finger laceration that needs a damn band-aid and a blessing before he can go to jail. Or the complete oppisite, people sending me 45 fucking miles to a call when you have a unit sitting 2 damn feet from it. Are you seriously forgeting where you put your trucks? You have a GIANT fucking map up at dispatch that updates every 1 goddamn second that showes you where every single unit in the county is. It's in real time. Just fucking look at the damn thing and figure this out. You get mad when we dispatch from the street, but we get pissed when we pass each other going to calls. So do your job. There is One person up there who sole job it is to watch that map. and figure out who needs to go where. Thats all you do, so Fucking do it.

Okay, that is all.

Im getting down.

Rant over

2010-02-10T17:05:00.002-05:00

SNOW DAY!!! er...night. This is just crazy talk for my little coastal town. If the roads weren't still wicked icy, I would drive out the the beach and get photos of the snow on the sand. So just because it snowed, didn;t mean that people were any less retarded about calling EMS. Middle of the freaking blizzard (By beach people standard) "Medic One respond to such and such address in the ghetto for a sick person, no further 43 (information) this came from a 3rd party caller. We will send 90 (police), however they are also extremely 10-6 (busy) dealing with...well...you know what it's like out there" First problem with this transmission the address they gave us does not exist. I know this from working The City for a lifetime and a day. There are two streets in The City one is a Street and one is a Court. They dispatched us to the Court, however, I did know that it was in fact the Street. Second problem with this was 3rd party caller, unknown why we were going and we were not getting police? I know they were just as busy as us, but hell, the last time I got sent on something like this we were sent into an unsecured, violent scene. I call dispatch, knowing full well how busy they were, but I needed to know what the Fuck I was getting into. Turns out it was a house with a call history, and a nonviolent dude living there. So okay, we went along. Pulled up, I slipped on the ice a few times and made it up to the door. knocked several times, no answer. "County, Medic One, no answer at the door any more 43?" "Neg Medic One, go ahead and get 10-8 (back in service) if they need us they will call back and you have three more calls in your district" Okey-dokey. We got called to a psych, psych, assault, psych and a chick with her period. I had one guy ask me "What took you so long?" after he called because he had non traumatic leg pain times three days. "Sir, have you looked outside your window? " "Yeah, I looked...thats why I called, I can't drive myself, it's snowing." "Well, then you should know I can only drive this top heavy 3 ton skid machine only about 20MPH right now, you are lucky we even made it here, so get into the ambulance" We had 12 calls last night, not one needed a trip to the hospital, but all of them called EMS to take them for there perceived "EMERGENCY" I heard at one point another truck go out for a "depressed person at the pay phone at the KMART" And another go to some "my power is out and I need you to check my baby's feeding tube" Last I check a PEG Tube does not require electrify to work. I think out of the hundreds of calls we ran last night, maybe a handful needed EMS, several MVAs, and a couple of significant SHortness of breaths. But all and all I think people were just sitting around thinking of reasons to call 911.

WHen the snow finally quit and turned to sleet, the roads got all slushy and slick, people running in the guardrails, other cars, mailboxes. For as many Yankees as we have in this town you would think they would at least know how to drive in the snow. But no, its like they cross the Mason Dixon and forget about the white stuff.

I did get to do one thing though...Make a snow angel...OF DEATH!!!

CSPINE

2010-02-03T13:54:00.002-05:00

Oh man. So You know that little voice in your head that tells you things, no not those voices, but the voices on scenes that tell you "Why don't you do that 12 lead" or "Take a deeper look at that laceration" or "CSPINE!!!!!" Listen to them. Especially the Cspine one. You will never ever get questioned for cspining a patient, but you can always get question as to why you did not cspine one. For those of my blog followers who are not EMS or healthcare workers cspining is when we put a hard collar around the patient's neck and then log roll them or slide them without manipulating the spine (or as little as possible) onto a long boars. This acts as a large splint as sorts to keep the neck and spine in line. This is to minimize further injury and hopefully if done correctly or if the spine isn't already too injured to minimize the risk of paralysis. Okay teaching over.

Okay. So we come across patients all the time that enter that grey area of "to cspine or not to cspine" all the time. Drunk, fell down, answers some questions, but slurring a bit, has a lac above the eye, not c/o neck or back pain. or How about got into a foot pursuit with police, collapse, unresponsive on your arrival, but "didn't really fall that hard" or Found down, no idea how he got there, no idea where he is, no trauma noted. or Seizure pt sitting on floor, still kinda postical, but can't tell you if he fell on the floor or was already sitting. I say ALL of these need Cspine considered if not just done. It takes five minutes. Yeah, its' kinda a pain in the ass, but it's five minutes that can totally save your ass later. You have no idea if that fall caused a C4 fracture to that drunk kid because he's too drunk to know his neck hurts. So you board and collar him and there's nothing that can come back on you when it shows up on his CT scan that he has a broken neck. And you will never have an ER doc fault you for putting your patient in Cspine precautions, if you do, that ER doc should have his head scanned right along with your patient's. So until they start putting Xray machines and CT scanners in the meat wagons, keep on listening to that little voice that screams at you to put that patient ON THE DAMN BOARD. Because it may mean the difference between having a job as a medic or having one as a taxi driver. And I'm talking a real taxi, like little yellow and black ones, not Cabulance that we sometimes are.

2010-01-21T19:52:00.002-05:00

So I'm having a bit of a life crisis as such. As some of you may know...or not know I turned 30 last November. I also started Art School studying Photography and had a bit of breakdown at work (mostly because of lack of sleep) I am now looking to relocate to a new city. As the lyrics of the Modest Mouse song The World At Largesay "Gonna find another place, maybe one I can stand. I move on to another day, to a whole new town with a whole new way" So I'm in a bit of a spinning panic. Looking for a job, a place to live, and new school to finish my degree. Then when I get done, what will I do? Photography is not exactly the best paying job. And weddings aren't exactly my favorite thing to do, mostly because I think brides are a bunch of whiney bitches. But I don't want to be a Paramedic for the rest of my life and my spine isn't going to let me be a paramedic forever. I don;t want to be a drug addicted 40 year old cripple because my spine has turned to dust. Should I study graphic design too? Should I study Art Management? Should I scrap the whole thing and study squidfish in Borneo? WHen did I wake up 30 and all my friends develop a life but me? When did they get settled into their lives and I'm still figuring mine out like some 19 year old.

Things I have Learned Working Nights in The City

2010-01-16T07:18:00.002-05:00

I love working nights downtown. I have now been in The City for about two years now. I have gotten to know my cops, my firefighters all by name, they have gotten to know me, even if most of them know me by Angel and not by my actual name. They know that I am afraid of the horse cops and that I although the drunks can cuss at me the minute they start swinging or worse spitting is the minute the lose the ride in my truck and they earn a pair of bracelets and a free trip county jail. They also know how I take my coffee (soy or cream depending on who's buying, lotta sugar) So in the two years working in The City of Dixie I have learned :
1) The statement "Fuck You" will earn you a beat down, a tasing and most likely a public drunk and disorderly. And the cops don't like when that statement is aimed at either them or us.
2) Crazy is not illegal nor does it mean you need to go to the hospital. Unless you are a threat to yourself or others there is no need to go anywhere. Just because you put tinfoil in your hair to keep the aliens from stealing your thoughts or that you talk to your dead cousin that lives in your shopping cart does not mean you need to go anywhere, sometimes you need to explain this to the officers or the people that run the shelter.
3) Drunk is NOT a medical complaint, I was drunk two nights ago, woke up with a terrible hangover. Took advil, drank gadorade and plowed through it. The college kids can do the same. Unless they are unconscious and can't hold their own head up, they can sleep it off in their dorm room, not in an ER.
4) The projects are a safer place to park an ambulance than outside of the dorms
5) It's Sugar not diabetes. It's High Blood, not Hypertension, It's Water Pill, not Lasix. It's fluid on the heart or failure, not CHF. "Sticky Pain" is a legitimate description of chest pain and a 12 lead needs to be done. "Shortness" requires O2, Skesures require Ativan
6) Sometimes it's just easier to take them than it is to argue with them.
7) Cspine EVERYONE who in laying on the sidewalk and smells even a little like alcohol
8) When the COPS say he's dead...Fucker is D-E-A-D
9) On shooting scenes, look for tiny things like business cards marking the shell casings, especially if the crime scene unit isn't on scene yet.
10) They all lie.

2009-11-16T07:05:00.002-05:00

It's like the EMS gods knew I needed that. A shock, a wake-up, a little thing to keep me going, Something to tell me why I do what I do. Why I deal with the bullshit, why I listen to the lies my patients tell me. They gave me a magled car with a twisted up patient and didn't kill him. They let me care for him, let me get an impossible IV, let me administer drugs that are so powerful I literally take away the patients ablity to breath on him own...just so I can turn around, put a tube in his throat and breath for him. And though he tried, he did not arrest on me. I got him to the hospital. I saved this person at 60MPH. I needed that. The Gods just know...that on the verge of burning out compleatly,that they need to give me some reason to put on the uniform and go to work.

When you pull up to a scene like that and see all the lights and then the twisted up metal, and after your first thought of "What the fuck now? How did that person get in the situation he is now trapped in?" something just turns on and you are ready to go. I just threw on my little blue helmet and dove in. Really...what the hell makes a person do something like that? Most people try to GET OUT of the mangled vehicle, not get in while the Fire Depatment cuts and bends the mess off and around you. Instead, we climb in cover ourselves and the person we are trying to get out with a fire blanket and wait to be rescued. It's sort of a wierd logic. But we do it, we don;t (hopefully) know whoever this is that we now share a small cramped space with, trying to figure out the best way to clear the airway, check a pulse and then get them out. We blindly jump in and hope for the best. Sometimes, like last night it works. Others, not so much. And then later you relize that EVERY scene is like this...You are going on blind faith that who ever just summonded you at 4 in the morning is not going to answer the door with a shotgun. What makes a girl come roll up in a huge flashing box on wheels into the projects to find a GSW laying there, surrounded by cops and bystanders, and go well, just another day at the office, better get to work. This is my office. The streets are where I do my paperwork. and it sure as hell beats sitting in front of a computer all day everyday. And then there is Naptime. yeah, If I'm not doing anything, I get to sleep...on the job...or watch episode after episode of 30 Rock and NCIS.

So yeah I have a pretty cool job. I drive a 3 ton truck with sirens and lights. I show up and can actually bring someone back From DEATH. Which is sweet. How many people can say that their job is helping people and driving fast.

2009-10-02T04:40:00.002-04:00

I have been neglecting my little space of the interwebs. I don't know if has been writer's block or school or work but It's been to long. I had a bit of a breakdown at work. I think it was a mix of lack of sleep and taking on too much schoolwise. Art school, contrary to what you might think, is not easy. Creativity is something you either have or you don't and you can't switch it on and off. When it's on, baby it's on, but when it's off...it's off. So I had two weeks off from work, concentrated on my art for two weeks, cleaned my apartment, uncluttered my mind and started over.

I came back to work much better. Back to The City. I love The City at night. The characters, I have my regulars, like one who calls because "the shadows are smoking crack and makes me short of breath" I know which addresses are sick, which are not sick, which are crazy, which just want someone to talk to, which need the police to come with me. I love walking up and even though we were called to a nosebleed I hear, "Man just shut up and let EMS look at you, You got a stab wound in you damn chest..." So I am back, back to work. Both medically and creatively.

2009-05-16T03:51:00.003-04:00

http://digg.com/people/EMT_Fired_Over_Facebook_Photo_of_Murder_Victim

I read this was sickened by it. How could anyone is my line of work think this was okay? Not only was he violating all kinds of HIPPA laws, but that poor family. Now, I know I blog about my experiences as a paramedic. But I like to think I keep it light, I want people to understand that I love what I do, even when I'm up to my eyes in alligators, I still enjoy the little world I live in.

Now...

I have a real paying gig. The Derby team that I have been working with (pro bono, portfolio work) is having me shoot during thier promo night out. This little Medic is excited.

2009-05-04T08:04:00.002-04:00

I had a friend of mine demand I post, I told her I have about 7 unfinished posted saved, So I'm gonna try and finish this one becuase it's been quite a while since I've posted. School has kept me quite busy. Im living on Starbucks and very little sleep. But I creating some of the best work I have in a long time. I forgot what it was like to truley love photography and taking photos. Along with working, I have hooked up with the local Roller derby team and have become thier photographer. They have taught me alot, not just about photography, but about being part of a team. And it's a great release and change from the work on the ambulance.

I also got a phone call from my cyclist yesterday, he is doing well and it was good to hear from him. He is speaking to group of graduating class of paramedics today and needed me to fill in some missing gaps from his accident. He is my reason I put on my uniform every shift and to be honest, that phone call came at a good time. I needed that reminder right now.

So this was just a quick post, just to let everyone know I'm still around, I'm still on the ambulance. School is keeping me busy (I made Dean's List too!) I'll try and do better about posting.

I ain't that normal

2009-01-31T12:09:00.001-05:00

I ain't that normal
Originally uploaded by artist in the ambulance 190.

The Pineapple

2009-01-31T12:08:00.001-05:00

The Pineapple
Originally uploaded by artist in the ambulance 190.

Chasing after it

2009-01-31T12:07:00.001-05:00

Chasing after it
Originally uploaded by artist in the ambulance 190.

2009-01-26T21:30:00.002-05:00

Life has gotten a bit easier. No less busy, but easier. All this in spite of having a difficult partner and school keeping me running around, with a camera most of the time. I'm am on a truck I enjoy in a district I love. Though I do occasionally have the urge to duct take my partner to the the stretcher and sent her down the ramp at the Old County Hospital. But the Firefighers and police are cool in The City. We are busy enough that the night goes by at a decent speed. We also have more of our "frequent flyers" in this area. The ones when you hear the address, you know exactly what you are walking into, whether its a bad CHFer, the dialysis crackwhore who is fine when you get there and within seconds of arrival goes downhill, or the crazy old lady with all the cats and vodka. You just know them, you know their names, you know thier allergies, you know that NTG doesn't touch the pulmonary edema and the only thing that will save them is a fast ride and CPAP. There are always suprises, like pulling up to the Stretch Limo that was involved in a minor MVA, with 22 drunks piled into it. You know it's bad when I yell, I had to yell on that call. "You. Yeah you, go stand over there. Unless you legally make this patient's medical descions for her, your input is no longer needed"

And why is it that Overdoses ALWAYS lie to you. Even when you just brought them back from the brink of Death with the "wake-up medicine" Even when you pulled the needle out of their arm so you could start your IV.
"How much Herion did you use"
"Dude, I don't use that fucking shit"
"I'm gonna ask you again, slower because maybe you misunderstood me and don't lie to me How...Much...Herion...Did...You...Use? And don't call me Dude, I'm not your buddy. I'm the medic that just brought your dumbass back to life, show some respect"
"Dude...I mean Ma'am, I don;t use herion"
"so that was just...what?...insulin in the needle I just pulled out of your arm."
They truly think I'm stupid.

Art school is harder than you think. It's not just drawing and taking pretty pictures.

2009-01-12T00:18:00.002-05:00

Hello friends. Yes, again I am sorry about the long breaks between posts. I have been suffering a severe case of burn-out and haven't flt much like writing. But alas, maybe it will make me feel better just to let the word flow...good or bad, without a real care on who reads this. I'm not gonna speak about any strange or twisted calls, because really, I havent had any. They all have been your normal Shortnesses, Chest pains, catching seizures and "I gots the Sugar". Oh wait, I did help with the delivering of a baby. That was cool. Death (AKA, me) bringing life into the world. Nice change of pace. Got to tuck those Wings of Darkness back into the uniform for the night. But really other than that, been pretty uneventful on the call front. I'm back on nights with partner who frankly...sigh. Yep, I think my Senior Crew Chief is afraid he gonna come into work and find that I have strung 'em up from the ceiling with my technical rescue harness, refusing to let her down. I promised him that I wouldn't do that but I could not promise that the words Fucking and Idiot would not cross my lips. Especially now since I'm going back to school and I will be running on Nicotine and Coffee instead of real actual sleep. My fuse was gonna be a little shorter than normal.

So here I am, 29 years old, on the eve of my first day back to College, well Art College, I mean my first class is entirely dedicated to the View Camera, working towards a goal to get me the heck out of EMS. To go be creative. Away from the Death. To make pretty things.

2008-12-09T21:46:00.003-05:00

Well people, two things today. Did you know that one can shear the ENTIRE IV cath off? Not a peice, the WHOLE DAMN THING. Me neither. But it happened. I saw it, I was witness to it. My trainee for the day did it. I was on the radio, encoding, forgeting that I still had the radio keyed up, when he told me what happened, I went over the channel "You did what...fuck." Then cussed again when I relized that I had dropped the F-bomb over the radio. I apologized, then told the hospital they were not gonna believe what happed and I will explain when we get there. That was impressive. I have never seen anything like that, and apparently, it has never happened before with a peripheral INT; at least not where we could find over the internets. Centeral lines, sure. But not peripheral sites. But everything worked out, and the pt was turned over to the hospitals staff with a slightly brusied arm and a missing Cath tip. The hospital is still trying to find it.

2nd thing...I got my acceptance letter to school....and my loan approved. So I am now $27000 in debt. But I'm gonna learn me somthing. I am still working full time for a while at least. So I will still be posting as my paramedic self. With school updates thrown in. And more photography, of course.

2008-11-27T14:20:00.002-05:00

Well I have decised to go back to school. These past few weeks at work have made me rethinking paramedicine and the reason I'm in it. The cincher was after I got moved out of a district I love, away from a partner I get along with, and am not longer under the supervison of Supervisors that have grown to trust me. And they did it at the holidays, which has me working on every holiday but Thanksgiving day. I had my whole holidays planned. But because I am single with no kids, the holidays apparently mean nothing to me. The move was caused by something that didn't even involve me either. This among many other things have been leading me to this conclusion of going back to school to finish my BFA in photography. This job has gone away from Emergency Medicine and has turned into a "let us hold your hand and sing fucking Kumbaya" with the so called sick and dying. I am now forced to be nice. If I don't coddle my patients I may get a complaint and then I'm called into the principle's office for an ass chewing. Now I am normally kind to my patients, but then I have a patient throw a stack of Medicaid cards at my feet telling me "If you want it, you can pick it up and find it" I have a hard time biting my tounge and continuting to play nice. It's the ones that demand respect, but refuse to give it to me that piss me off. They feel that I am there to service them, not care for them. They talk down to me. That I am below them on the social ladders. So to them I say "I am here to save your ass, not kiss it"

I have grown tired of this. I am burned out and all thats left is a broken medic with a broken spirit. So When I walked into Art School, I could feel the energy in the halls. The creativity came back. I walkedd the halls of that place and I felt alive again, amoung the creative misfits. I had forgotton that feeling. I used to get it getting on the ambulance and running the lights. Not anymore, so I now think my lifespan as a medic is coming to an end. Art is calling me home. So now, a year shy of 30. I am going back to school. I can now see the light at the end of the tunnel.

Today's horoscope

2008-11-13T07:15:00.002-05:00

I'm not one to put a whole lot of thought into horoscopes, but this was mine for today

Scorpio (October 23-November 21)
11/13/2008
You may not be willing to accept the advice of someone else today if you don't think that he or she has enough information to form a clear opinion. It seems to you that others are willing to oversimplify the situation for the sake of expediency while you would rather delve into the complexity, even if you can't decide what to do. Be patient; solutions will continue to surface over the days ahead.

I'm dealing with a problem at work right now that I don't really have a solution for. Well, I do...but it includes explitive ladden phone call and a possible day off without pay. Not really a solution. I want a REAL answer. A fix. So I shall be patient. Let some of the feelings settle. Form actual thoughts, and maybe get something done

Lesson learned

2008-11-05T09:59:00.005-05:00

So I along with most of America voted yesterday. I am not stating here on my blog who I did or did not vote, nor my veiws on, well anything, as this is not a political blog. If you want that go read Slate or something. I am just a paramedic and this is my blog. So Back to my adventures in voting. I had just got off work, after working all night. I didn't even go home to change out of my uniform. My back hurt from lifting patients up off the floor. I had been puked on and had just gotten off the phone with the coroner 20 mins prior. (I had a woke-up dead) I was tired. I was ready to just go to bed. But I am an American, and this is just something I had to do. So I drive to my voting place ( a local Elementary school) and the parking lot was packed. I had to park a few blocks away in someones front yard. I walk in and get into the line. I'm there for an hour. I'm playing a game on my iPhone, listening to music. Blurring out the maddness, the bitching about the lines, the politcal bickering. I'm in my own world. until I feel a tap on my shoulder. I pull the ear buds out of my ears just in time to hear "She's done caught herself a seizure!"

Sure enough, next to my, across the hall, an elderly woman had passed out in line. Her neice thought she had a seizure. So I go over, and see if I could be an assistance. (I'm still in uniform, remember) The woman was out cold for a few seconds but was coming back around by the time i got down on the floor to her level. Someone screaming about Seizures and "Sugar". I block them out for a minute
"You Okay?"
"Yes. I think so."
You hurting anywhere?"
"No."
"You have Sugar?"
"No, but I didn't eat breakfast."
"Well you fell out, Sit here for a second, Whats your name and how old are you?" She told me and I called my dispatchers. As I'm doing that I get pushed out of the way by some woman screaming about "Is there a doctor in the house!" and "Does any one have a BGL machine" I get off the phone. And in my head...Who is this woman ( she never idenified herself as any sort of medical person) and what the fuck, Lady, you are in an ELEMENTARY SCHOOL, who do you think has a freaking BGL machine? I lean back down and continue speaking with my now patient. and this woman continues to yell. "she has no radial pulses!. She severaly hypotensive!" she has no radials" Good Greif. "Mrs. M? do you think If I get some helf you can make it over to that bench so we can get you up off this floor?" She said "I can, I'm just a little weak"
"Well lets get you up."
Screaming lady-"You can't get her up she has no radial pulse she will pass out again, she is severly hypotensive"
Me-"Then we will deal with that, But I would like to get her up off the dirty floor, out of the crowd. I already called an ambulance. I work for EMS."
Screaming lady-"Well I ..." and she walked off. well damn if I knew it was that easy I would have said that 10 mins ago. I got some help to get her up and we when to sit down. We got her taken care of. She got to vote. When I went back in I had lost my place in line. I stood there for a second, contemplating what to do. The people running the polls were no help. I didn't want to get back in line a wait 4 more hours, but I still wanted to vote. It wasn;t until a young woman about my age holding a 6 month old infant said "You missed the riot".
"Did I? was there Bloodshed, I hate it when I miss bloodshed."
"Na, you helped that woman?"
"Yep, and now I've lost my place in line"
"Here jump in front of me, you were here at least as long as I have if not longer I saw you." Now she had been holding this kid for god knows how long
"I can't do that, you have you son with you and have been waiting too."
"Don't worry about it, jump in."
So I did. We talked for a few minutes and her little one kept babbling at me and pulling at my hair. I asked her if he would let me hold him. Since she let my cut the line. I held the little one for a while. we had a very deep conversation about the economy ( a little one sided) and health care. Then he napped on my shoulder. Mom and I chatted with the others in line. The rest of the voting was uneventful. No more falling out or seizures.

So I voted. My patient voted. And I learned not to wear my uniform to the voting booth if you have been up all night.

Competition

2008-10-26T01:20:00.003-04:00

These are photos from this years Competition. Link to my Flickr Page.

This Competition was in Charleston SC this year. It is a competition open the EMS systems in North and South Carolina. This years winner was Greenville County EMS. Congrats to them.

Senerios were: an explosion at a camp site. One DOA, One with 2nd and 3rd degree burns with Airway involvement, the ambulatory pt who was deafened by the blast, and the "distracter patient" an unresponsive, apenic pediatric with airway obstruction.

The 2nd one was: A pair on a motorcycle rear-ended a construction truck full of rebar. Several impalements, that make C-spining somewhat creative. The critical go unresponsive and vomits (I will never look at pea soup the same again) The "distracter patient" was the driver, who was having CP, now collaspes and codes.

So here are the photos...
http://www.flickr.com/photos/strangelittlegirl190/sets/72157608361515378/

The Innocents

2008-09-27T12:13:00.003-04:00

Again, It's been a while since my last post. Had a few calls that made me want to walk out and take a long needed vaction, one that made me sad, one that made me angry, both Pediatrics. First. I had my first pediatric arrest. We, as paramedics, dread this call. We train over and over for it. We run the drug calculations in our heads, the tube sizes, the algorythms, so that when that day comes and a screaming mother hands you that limp, not breathing child, you don't freak and fumble your way through. And yes, your first you will freak and you will fumble, but do it on the inside. The ET tube was too big, I needed the smaller one, shit! it's not ready, what the dose for the epi again? how many doses was that? is it time for another? Is that IO still flowing?....Watch the fucking turns, I just got the fucking tube!... Are those readings right on the end title CO2. Keep up the CPR...FUCK! I gotta encode the hospital! All on the inside. On the outside, we worked like a machine, nobody screaming, everyone doing the task at hand. Except the Fucking turns remark, I did scream that. But despite all the good we did, the airway, the drugs, the CPR, the child had been down too long, the tiny heart had been still for too long.

We work for peds. We want them so badly to live, even though we know, in that paramedic part of our brain, that there is no hope. They are so young, they haven't had time to play, time to learn. So we fight for them. We get thrust into these calls, and this for me was my nightmare call, tiny little baby in cardiac arrest, but we get thrust into it, the parents looking at you with such hope. Hope that you can perform some miracle and breath life back into this child. I still have the mother's screaming in my head. When We got to the hospital, I could barely give turnover to the hospital before I fell apart. Even though I knew there was nothing we could have done for this child, this child had been down way too long, You cry for these tiny little patients. You pray to whatever Higher Power you pray to....then for the next few days you play the call over and over in your head until you are satified that everything that could be done was done. And you are still sad. I didn;t sleep for several days. But you call your support system, those other paramedics that you call after calls like this and you lose it. If they are good, they will talk you back from the edge and back onto the truck so that you can help the next one.

My next one came yesterday, We rescued a 6 year old and 9 month old sibling, who had been abandoned...for 8 days. The 6 year old kept as good of care of the infant as a 6 year old could. Fed the infant a bottle twice a day and also made toast and jelly for himself (he was covered in strawberry jelly). When asked how he knew how to make the bottle, he answered very matter-a-factly "You just mix the powder and water together in the bottle and shake it up" and looked up at me like DUH, don't you know anything? You ARE a grown-up. The I asked if if he changed the baby's diaper, "No, I don't know how. I'm only Six!" But because he took good care as he could of his brother, this had a good outcome. I wasn't working two sick children. Other than a severe case of diaper rash, a snotty nose and a slight fever the baby was really okay. The little one when I held him just curled up close to me and slept. (not lethargic, limp sick baby sleep, but normal baby sleep) The six year old was very active, totally obvious to why the Police and Paramedics were there. He was just so excited to ride in the ambulance. He played with all the switches. He really like turing the suction on and off. I think it was because it was loud and we picked up band-aids with "Magic" We also like the stethescope. We listened to his heart then his brother's and it sounded like a drum!

I wanted to take them both home with me and watch Disney movies on my sofa. I wanted to show them what it was like to be loved and wanted. Then the anger came. Not toward these two children, but that mother who left them alone for so long. I had never wanted to cause physical violence to anyone. How dare she leave. I'm almost happy she was not found before we left, nor was grandmother. I would have gotten a complaint. I would not have held my tounge. I held both those kids all the way to the hospital. We played and sang. The baby looked at me like who is this crazy woman, singing with my brother. But he still giggled when I tickled his little round belly. They probally got a warm bath and the best sleep that night.

These innocents, We care for them, we fight for them. We want to love the unloved. It was hard to give them over to the hospital. But they now are getting cared for. And that is the best outcome.

Thanks

2008-08-24T23:57:00.002-04:00

I want to thank my boys in blue today. My system gets along very well with the other public servents. Fire gets along with police, police gets along with EMS, EMS gets along with Fire and the circle goes round and round. We all take care of each other. It's like we all know we are here for the same job, to make sure that the public of our coastal city stays safe. Even if the person we are taking care of is a violent crack dealer. I had a very large, potental violent patient today that was tased. He had been using cocaine all day. Possibly injested another couple grams more of crack, then was tased several times to be controlled. We were called for a posted tasing exam, as per protocol, we placed him on an EKG and her was extreamly tachy, in the 150s. But The Cops, because of the patient's violent potential and his size (he was a BIG BOY) did not want to put him in the box with two female medics. "I know you girls can hold your own back there, but he tried to kick MY ass and I have a gun AND a Taser, I AM NOT putting him back there with you two." I explained to the cop that he needed to go to the hospital, his heart could explode due to the tasing and the coke. The cop offered to take him the hospital in his crusier, which was a great. In the same breath I also wanted the best for my what was now my patient. A cop, even on the way to the hospital has little medical training. If he was to arrest in the back of his crusier the cop would be in a world of hurt. So For the good of all invovled I convinced the cop to let me ride with him. With my partner driving behind us in the ambulance. That way if anything happened I could work the patient, the cop would stay out of trouble because he did all he could to keep us, the medics safe, and the patient under medical care. And Pateint care was not compromised or discontinued. It was in the best intreast of all parties involed. So we look out for everyone. Not just the sick and Stupid.

Zebras

2008-08-22T20:29:00.002-04:00

Weird medical calls. That seems to be my specialty. Think is psych, wrong answer. It was a bi polar trying to make the manic thoughts go away took to many of the friend's medications. Ended up with the body eating it's own muscles and kidney failure...oh and hallucinations of spiders, lots and lots of spiders. Next one...Panic Attack. No way. The EKG showed a strange narrow complex bigemeny and ecscape PVCs. I did 5 12 leads because the rhythm kept changing. One did show a type 2 AV block, but then the heart onverted itself back into the odd sinus arrhythmia I started with. I looked it up in one of my cardiology textbooks. Escape-capture bigeminy (ectopic atrial escape, sinis beats with prolonged P-R) apparently. It was in the chapter of Blocks. Turned out pt had infarcted several days ago. An Inferior MI. Makes sense, inferiors tend to have strange blocks and such. How about a drunk homeless frequent-flyer. The last time he was in my truck he spit at me, then proceeded to urinate all over the back of the box. The only reason cops won't take him in is because he refuses to ambulate, so they call us to "check him out" so they can arrest him. Only this time he has a BP of 70. Goddamnit. Turns out he has been drinking and doing herion all day.

This is why I am a good medic. I tend to be overly cautious. I have come across to many strange "zebras" to think otherwise. Like my young patient who stated it hurt to breath "right here", but whose vitals were all normal. He ended up with a spontanous Pneumo. Found that with a stethescope. I do 12 leads on just about everyone. But I have found more MIs on Pts with NO Chest pain , than pt with classic signs of Heart attack. Old lady vomiting...Huge Head bleed. Middle age SZ...brain tumor. Athlete in training has abdminal pain...Aortic anyrism. Young woman violent and hallucinating...bacterial menigitis. No wonder I'm a hypocondriac. I think everyone is sick and dying. Good thing I guess in a medic. You don't want a medic who thinks everything is bullshit. But sometimes the hoofbeats are just horses, just not with me. It's always a puzzle. The EMS gods playing little games with me. Like they sit up there in their ambulance in the clouds going "Let's see if she can figure this one out..."

My Reality In B&W

2008-08-07T00:44:00.002-04:00

http://www.youtube.com/watch?v=AOsGIE56g5M

A YouTube video of stunning B&W photos. This is my reality.

Enjoy the Ride. I do.

(I believe this is somewhere in South Africa)

Some needs to call the paramedics, Oh crap I am the Paramedic

2008-07-26T23:01:00.003-04:00

So this morning I was sitting at the light in front of my house, waiting for it to turn green. Which sometimes it doesn't because it sucks and it stays red for ever and I have to call The Voices, who then call the city police voices, who then call traffic, who then fix the light. Well this particular morning, I was waiting for the light to turn, enjoyin my morning coffee an the new Death Cab for Cutie album, when I heard sirens and lots of them. I first think, how odd, I don't remeber Sirens in this song, them it dawns on me, its coming from outside. I see a fire truck, then another, then a ladder, the two squad cars. Phew, something big is going down. I cut off the car in front of my that won't turn and continue on my way. I find out when they were going in such a hurry.
I turn down the road on mu normal route and they are all clutered in front of the school with a bunch of cop cars, but no medic unit. I see the vehilce smashed all to hell and a man with all the fire guys franticly doing stuff over a man with lots of blood around the head area. I fly past all the chaos, and pull into the school parking lot, jump out of my car, barely remembering to put the damn thing into park and rush over. I am stopped by a police officer, mind you I am in uniform. "Can I help you?" He asked in that I'm a bad ass cop voice, even though he looked like my seventeen year old cousin. I look at him thn look down at myself, and go "Well I thought I might be able to help you, I'm a medic"
"Oh...OH....yeah...YEAH, go see what the fire guys need!"
I go walking over. "Hey yall, I was on my way in to work, thought you might need some help." I hear from behind me someone yell "Hey capt, he's CAT 1!" (Damn near dead) I turn around and he is guppy breathing, clamped down, blood everywhere. One of the fire guys, goes "We got a medic!, She needs a pair of gloves!" I get a pair of XL gloves thrusted at me from somewhere (I wear a small normally) And right at that moment I had a oh fuck moment. I was the only Paramedic. With nothing but a BVM and a pair of gloves. No drugs, no ambulance, no monitor. And at least six men turn to ME (gulp!) and go "What do YOU need us to do?" WHAT THE FUCK DO YOU MEAN "WHAT DO I NEED YOU TO DO" Oh Jesus Christ and all that is holy, I am now in charge. I am the senior Medic on this scene now. And All I could do was Bag this man. Breath for him. He still had pulses. We did have CSpine stuff, so we were starting to CSpine him when the medic unit pulled up. And never in my life have I been so happy as to see an ambulance. That 3-5 mins it took the medic unit to get there felt like an eternity. But when it did show up. I was happy to turn over care.

But I did have a Oh Fuck Me moment. A someone needs to call a paramedic, Oh shit! I am the Paramedic moment. When everyone, even though they were completly able and competent, turned to you. Because You have Paramedic in front of your name and goes, "Hey, what do you need?" I was alot of responsiblity that hit me all at once. I wanted to run away. But of course didn't. I had My fire guys taking care of me. And they did a wonderful job. So again I thank them too.

Gut feelings

2008-07-04T23:07:00.002-04:00

My last post was about assessment. This one is about gut feelings. I get them. I know when I'm about to walk into something bad. And it's usually when I get it, very bad. I got it on the way to the Airport and when we walked in to a cluster of a cardiac arrest. (We brought him back, not only brought him back, but had him walking and talking, CAOx3 by the time we got to the hospital, they were doing CPR when we got there, he was D-E-D dead. and very much alive when we dropped him off at the hospital) I got one when we forced entry into a house and found a pt laying prone on the floor who looked up at us and took her last breath. I got one when I listened to that kids lung sounds from the last post. And most recently got one with a pt who called us after a syncople episode in his backyard. Pt was SOB and passed out. Even out in the heat pt was pale, cool and diaphoretic. You know how they teach that kis are either sick or not sick. Well this works on adults too. They are either sick or not sick. And this pt was very much sick. S-I-C-K. Cardiac sick. Pt had that look. Had a gut feeling. So pt got high flow O2, and a 12 lead. which came back normal. So pt got two more 12 leads 5 mins apart. Also normal. But something was not right. Pt was sick. Pt was hypoxic, fighting to breath. SPO2 was normal. But Pt was fighting the mask, and skin condiction never improved. Then as we were pulling into the hospital, pt respiration increased from 26 to 38. SPO2 dropped and near syncope. One more 12 lead. HUGE ST elevation in inferior and anterior leads with some slight elevation in lateral leads. The pt infarcted right in front of me. nearly arresting. I RAN him into the ER waving 4 12 leads in my hands. "Doctor! Doctor!, you need to come with me, He's literally infarcting right now! right as we pulled in. the bottom two are the first ones I did, the top one is the one I did right now like 30 seconds ago"

So gut feelings. Listen to them. They are normally right

Assessment

2008-07-01T10:16:00.003-04:00

Don't you love it when nothing else is wrong, but there is one thing, one symptom, one minut finding that make you sit back and go, "Self, something is totally fucked up about this." You look at your patient, who looks fine, whose vitals are stable, but that one finding, that one thing is signifigant enough that your gut is screaming at you. I had that the other day. A young pt who had pain in inspiration "right here" and he pointed to a point on his chest on his right side. "A rubbing sharp pain?" I ask. "
"Yep. Excatly."
Pluresy. His vitals are ALL stable. Normal Sinus on the EKG, 99% SPO2 on room air, I put him on a canulla. respirations 16 non labored. Not fighting for oxygen at all. I listen to his lungs with my handy dandy stethescope. High tech little tool we have, not really, but very important peice of equiptement on the ambulance. So I instruct him to take a deep breath and hear very clearly breath sounds on the Left, but nothing on the right. Whaaayayayyttt? Okay do it again dude, Deep breath. And again, nothing on the Right. I look at the monitor and everything is normal. So ONE more time, deep breath, and once more....nothing on the right. But still vitals stable and pt not working to breath. I ask again any shortness of breath. No. None. Just a sharp pain and he can put his finger on it. He doesnt want to go to the hospital. I explain that I can't hear air moving on the right side, thats strange. I have a gut feeling that something is funky. But how do you explain to someone about gut feelings? I convince him to go. and we take a easy ride to the hospital.
When we get there, I tell the staff. "I know I sound like a crazy person, his vitals a completly stable, SOP2 is 99-100%, respirations are 16, and he denies SOB. But I swaer his has almost no lung sounds on the right. I know all I have in the feild is a stethescope, not exactly a chest xray. But I swear, I listened 8 times, my partner listened. neither of us could hear. So we brought him to ya'll. So you tell me...can this be a spontanous pnuemo even though no other signs and symptoms piont to one?"
The doc told me that I was thinking the more deadly Tension Pneumo, a small bleb wouldn't show up so seriously. SO I did what I could do in the feild and brought him to the hospital. So good job. They would do a chest xray and figure it out. He wouldn;t try an diagnose a pneumo in the feild.
Yesterday, I stopped by the ER, it was not only a pnemo, but a big one. Needing a chest tube.
This my friends is what you find when you do a good assessment.
Listen to Lungs, know what the sounds mean, do the 12 lead on that 78 year old whose only complaint is weakness ( I found a huge anterior MI once that way, again, pt was very stable, vitals, only complaint was weakness x 3 days, but there it was staring back at me plain as day). I have had several medical mysteries recently, where the patient was absolutly stable, but something told me, put them on the monitor and then caught the 2 degree heart block or the stable Vtach (yep, had that too) don;t put them with you EMT basic partner, as competent as he is, he can't give amiodarone or interpert a 12 lead. CHeck the drunks BGL. Oh shit it's 567. Thats why he altered. Yes there are times that sometimes a fall is just a slip and fall. Listen to your patient. They can tell you many things. And also listen to what they are NOT telling you. Sometimes that can tell you more.

Losing at dodgeball sucks

2008-06-25T22:27:00.003-04:00

I'm getting lazy with my posts I know. Been busy, life takes over...blah...blah...blah and all. Getting settled into the new place. Work is work. Did ya'll know that losing at dodgeball warrants EMS being called. Neither did I. But when the player that gets tagged out refuses to speak and gets upset because they lost, EMS gets called. As does mom. Mom being no dummy realized what was wrong with dear sweet child, and kindly waved away the ambulance. Next time, she tells the kid, suck it up, we all lose at dodgeball every now and again. Today was calls like this all day. People who didn't call, third party callers. And also your typical hot weather calls. Faintings, falls at pools, jellyfish stings...the normal summertime on the islands calls. Not too bad of a day. At least it didn't storm today and flood downtown. Our fair city has terrible draining. Especially at high tide after a terential downpour. It tends to flood really bad over by the hospitals and on most of the normal routes to the hospitals. What should have been a 8 minute transport, turned into a 35 min roundabout tour of the city because the city was at a standstill because to the water. Glad it was only a broken ankle and not something life threating. Then when we left we run into a huge flooded area with a local news crew filming. I have learned from personal experience if you have to debate if you can make it or not, you probally can;t make it so dont try it, especially when a news crew is pointing a camera at you and your ambulance.

The new apartment is nice. The pool is even nicer. My days off spent by the pool.

back.

2008-05-24T22:22:00.002-04:00

Yes, I know its been a while. But before you all go yelling and hollaring, I do have a very good reason for no posts. NO INTERNETS. My internet has been down since the crazy hobbit med student moved out of the apartment. But I am now in my own place, complete with TV and cable internets. So I am now setting up my new place, with a short break to type this post. Other than moving haven't been too busy. Work is still the same. Actually our system has had a few bumps, but nothing I want to comment on really. We all have our problems. So we will leave it at that. But in my work life, everything is smooth. I work hard. No death, but now extreme life saving either. I haven't shocked anyone back to life in recent weeks. And the most notiable thing that has happened was I got threated by a drunk, mentally hadicapped man who told me "Unhand me you crazy woman or else I will fuck you up!" But my partner and the cops kept any fucking up from happening. But not before he let loose a lugie the size of my fist in my general direction and then he just cackled at me. Oh well it happens. well I will make this short a sweet as I have more boxes to unpack.

Okay here it is a new post

2008-04-21T23:09:00.003-04:00

Phew, I know I know I know. Been a long time. But I have good reason I promise. Had a bout of writer's block. Then I found out my lease is up alot sooner than I thought so I had to find a place to live otherwise I was gonna be living at the women's shelter that I have grown to know and love. But I have found a wonderful place to live. A place that is ALL my own. My first place that is mine all mine. I don't have to share with anybody. More rent and I have to work a little harder to actually afford it, but a space that is all your own is worth that extra two shifts a month I think. And it has a pool. So seriously, yeah, two extra shifts is worth a pool.

Man, yall...we were crazy busy this weekend too. That full moon thing is so true, and all but one was some BULL-shit. The one was one of our frequent flyers that everytime you see she is actully sick, but because of crack. You just go "Goddamnit!, You were doing so good! What the hell happened?!" and she shruggs, all while fighting to breath. You CPAP her, load her up with NTG and haul ass to the hospital, go any slower and you will be tubing her. You just pray the whole way that she didn't wait too long to call you, because you can't get a line so you can't RSI her and you for damn sure don;t want to nasally tube her, she doesn't care for the CPAP, so you know she ain't gonna like that tube shoved down her nose.

The rest were all just alot of uncooraperative people who thought that EMS were either taxis to downtown or "unresponsive" who were gonna "faint" everytime we tried to stand them up. And every one of our "fainters" were a good 3 bills give or take. i've already has back surgery once, I'm not having it again. so I' not gonna catch you. You can faint. Not one of our "fainters" hit the ground. They all somehow made it to either a sofa or a chair or somewhere soft. One even made it clear across the room to the sofa. It was a fucking miracle.

Then there was the drunk college kids. How do you drink that much? No Seriously? How? I've been drunk, really drunk. I broke my foot in five places I was so drunk. But I have never been so drunk that I was unresponsive and EMS had to suction vomit out of my airway.

Holy Crap Batman! I can raise the dead

2008-03-05T23:35:00.006-05:00

So I thought that my streak of death was still following me. But apprently the EMS gods had other plans for me today. We get called to a near syncope...oh and can you also first respond to the Seizure too, it's at the same place, we have another unit coming, they are just 20 minutes out. Sure thing my dear dispatchers.
Medic on scene...Are you fucking kidding me, you didn't tell me the seizure was in fact in cardiac arrest! I can't give too many details about the call because this being the internet, a a very public forum and I would like to keep writing and this is the kind of call that walks the line of "can I write about it without reveling too much in this kind of setting" but I can say the pt was in fact in cardiac arrest, meaning he was not breathing, nor did have a pulse, he was...in not so many words...Dead when we got there, but my dear readers, do not fear, by the time we dropped him off at the hospital, not only did he have a pulse, not only was he breathing on his own...but he was sitting up, talking, conscious, alert and orenited x3 and holding a conversation with us. And when we left him at the hospital, he was on a nasal cannula, and they were trying to find a reason for why he went into cardiac arrest in the first place. Yes...We did some "Third Watch", "Emergency", "Baywatch", "only shit you see on TV" kind of Paramedic Magic today.

I have no idea what happened to the near syncope, the other unit came...nor frankly do I care. I was to busy saving a man's life. With a little help from my friends.

I would also like to say a BIG thank you to the First Responders. Without them sometimes our patient would not walk out of the hospital, like our cardiac arrest today. They started CPR right after he dropped and frankly, played the biggest part in saving their friend's life. So thank you. Without them we'd have nothing to work with. Just want you guys to know that the Paramedics, we do apprciate what you do. We may not say thank you all the time. But here's mine.

THANK YOU FOR ALL YOUR HARD WORK GUYS.

Sick and Tired of the BS

2008-02-28T23:23:00.002-05:00

Now we all should know by now I am a very laid back medic. Rarely getting worked up over much of anything. Sure, my hands tend to shake through bad calls, not out of nervousness, but because the adrenaline makes me. I can usually work through it by just sitting back for half a second and saying to myself "Self...Honey...It' ain't your emergency" On the outside I'm cool medic. I'm Eh...It's just VTach Medic. On the inside I'm going "Someone should really call the paramedics... oh crap I am the paramedic." But Thats another post on another day. Today, whoa, was let's see what else we can find to bitch about day. And to top it off I have whatever the respiratory crud from hell is going around. I bought my partner three bottles of cucumber foaming hand sanitizer and a tube of Airboure and a can of Lysol that I made him use every hour today because damnit if he's gonna get sick too. Anyways, Bitch at the Medic day...good Lord, seriously. I have other things, more important things to worry about than where my partner's name plate is. Like where are the Narc Keys and are they still attached to my hip? Seriously we have already discussed that fact that it is missing and that it is getting remade. I sometimes feel like I'm in the movie Office Space...Yes, I have seen the memo on the TPS reports and no... I don't need another copy. I have 8 bosses, Bob...EIGHT. Okay, so we are out of 20 gauge INTs. I didn't;t get by our supply cabinet this morning. It's cool really. Everyone will either get an 18 Gauge or a 22 gauge or just won't get an IV. The world is not crumbling or coming to an end. Chicken Little, my friend, the sky is not, in fact, falling. We have plenty of oxygen and all the ways to deliver it, drugs and all the ways to give them, and the monitor/difibrillator is still sitting on the bench seat so I'm cool. I have all I need. My boots are a bit scuffed and my uniform shirt has a few drops of coffee on it leftover from a little spillage when we hit that bump at 45mph, but I still am ever the professional. I still speak to you, my patients with kindness and confidence. I may have no idea what's wrong with you (as what was the case the other night with my actually unconscious/ unresponsive 18 year old with perfect vitals and no reason to unconscious) but I will treat you as to the best of my ability and haul ass to the hospital if needed. So With all that being said...Very few things piss me off or get me worked up as rudeness. Don't yell at me unnecessarily. Don't speak to me like a child. Don't hang up on me. And don't EVER call a supervisor without talking to ME about what I did wrong first. It's childish and like tattling. I hate getting a phone call at home several hours or even days later from a white shirt bitching...er, discussing... that I am not allowed to be at a station when the other crew is home when I have forgotten all about staying that extra ten minutes at a station because I was shooting the shit the with crew and fire guys. I'm very respectful to you on the phone, I expect the same respect to be shown to me thank you very much. I state again, Chicken Little about the sky..NOT falling. We can all get along. Just show me the same kindness, patience, and respect I show you and we will have no problems.

Smile.

2008-02-26T02:46:00.001-05:00

Smile.
Originally uploaded by artist in the ambulance 190.

Distract and play

2008-02-21T01:06:00.003-05:00

We as paramedics get caught up sometimes in the swirling around us. Lots of people yelling at you from all directions from your 2 year old patient to the patient's freaking out mother to the fire/ medic first resonders who were on scene first to the other kids who saw the patient fall and then subsequently started seizing. HOLY SHIT PEOPLE QUIT YELLING AT ME! Okay one at a time. FIrst Thing...Mom... your little one is alert, awake and now telling me that she is two years old and her favorite color is pink. I can't go anywhere until I find out what happened. Quit yelling at me to start driving I have a Fireman hanging on to my bumper. Quit freaking out because when she sees you freaking out...she freaks out...now hold this oxygen mask right here.
Now...Fire Guy...Give me the short story...
Now Partner...Drive before this mom starts to yell at me some more that I'm not moving fast enough.
Phew...
This is what I had to deal with today. This 2 year old fell and hit head...HARD on the concrete driveway. Had what sounded like a seizure following fall and breif LOC. But on arrival of us, kid was CAO to normal mental for age. ANd did tell me she was 2 years old and in fact her favorite color was pink. She did not like me for about 30 seconds following a BGL check until I redememed myself with Elmo stickers, which she kept a death grip on in her little hand for the rest of the trip. Mom at one point asked why I wasn't doing anything "You know? medical?" Thats when I looked at her and go "I know it looks like I'm doing nothing, singing and talking and asking your daughter stupid questions like what color is my stethescope, But as I ask them I'm checking her mental status. She has no idea what day it is or who the president is. But she know who Elmo and Big Bird is and that who on these stickers. And she know who you are. And she knows her favorite color is pink. So if she answers those questions, she has a normal mental status for a 2 year old. And that is a very good thing. Means that there is a a very slim chance of a head injury. Also her Heart rate is right where it should be and her pupils are equal and reactive. I'm doing more things "medical" singing with her than you think. I can't do a exam with her screaming crying now can I?" That got mom to shut up. I was more than just an "Ambulance Driver" at that point. We got the child to the hospital. Gave turnover to the nurses.

You have to learn that with kids...distract. Play. Sing. Clap. Anything to get thier minds off the fact that you have needles. I particularly like stickers. Elmo Stickers are a huge hit with the under 5 set.

roamers

2008-02-19T22:32:00.003-05:00

System Status Management. I haven't decided if I like it or not. I'm on one of our three "roaming" trucks. Meaning I have gotten to know alot of parking lots and street corners. Now I don't mind the street corners. In fact, if it keeps the non roaming trucks in their station instead of driving around and out of parking lots...I say...Send me to the parking lot of the WalMart on Main, I'll sit. I've got an iPod with the entire second season of No Reservations and the seventh season of The First 48. Plug that bitch in the cigarette lighter and I'm good. Thats what I'm here for. I'll even pick up the radio and remind dispatch that "Hey Y'all, we are right here!" when they lose track of where they put us and sends the downtown truck to the island we are sitting on. But what I don't get is they whole we can't be at the station when the truck that is STATIONED at that station is home. Take today for instance...We were sent to way out there..then that truck came home. The dispatcher called the station and goes..."Is the roamer there? If they are tell them they have to leave." When the crew asked where to send us, the reply was..."Anywhere in your district is fine but just not your station." Are you kidding me? Really? So we left, and went two blocks away to the local pizza joint and got a couple slices and cherry cokes. Its ridiculuas really. But So goes it.

Other than that one issue though...I think I do like it. We drive around. I've seen alot of the city that I might normally miss because I'm stuck at a station all day. Last shift we drove to the waterfront and sat and ate lunch there. You just don't do stuff like that when you work at a station. So its not so bad I guess. Could be worse...I could be working INSIDE. ::shudder::

oh and PS...

Steve Berry thinks I'm Cool.

Love your stuff. You are one sick medic and I respect that
Best Regards,
Steve Berry

4:13 PM

did nothing

2008-02-05T22:58:00.000-05:00

So I was back to the streets today. The back problem was short lived, fixed with a couple of flexarils and lortabs. Thank God for that. Not too busy today, just one call. A seizure at a local supermarket resulting in a calm ride to the hospital with a postictal man who kept repeating himself. The rest of the day was spent sitting on various street corners discussing with my partner, who eats more discusting stuff, Andrew Zimmer or Anthony Bourdain. (I prefer Tony B. to the other but I just happen to like his crass, cynical attitude towards everything) Everyday can't be filled with lifesaving shocks to the heart. So there we sat for 12 hours, breathing disiel fuel, talking about fermented shark, pig entrails, and slaughtering goats and how I would never put half that stuff anywhere near my mouth. (I have been watching WAY too much of Anthony Bourdain's show on the Travel channel) Boring day really. One needs days like this though. You can't have balls to the walls days every shift, or else one would go nuts in this line of work. You gotta have sparatic do nothing days. Where you sit. And do nothing. And talk about...well...fermented shark, and pig entrails, and goat sluaghtering

The Beach

2008-02-03T20:52:00.001-05:00

The Beach
Originally uploaded by artist in the ambulance 190.

Twisted Tree

2008-02-03T20:51:00.001-05:00

Twisted Tree
Originally uploaded by artist in the ambulance 190.

oh crap

2008-02-01T23:44:00.001-05:00

"Are you fucking kidding me!" Was the thought that went through my head as I paced outside the hospital. Over and over that one phrase. I had just got done moving over this fat ass bullshit "I got rear ended because I was talking on my cell phone, wasn't paying attention, had to slam on breaks so in turn caused the car behind to do them same and they still hit me but now I have bullshit neck/back pain, so I'm now going to sue the ass off those poor college kids who hit me" MVA patient from my stretcher to the hospital bed. Now as many of my faithful readers know, I am very conscious of my body movements because of my history (I have had back surgery at the ripe old age of 27). Well, this time even though I was very aware of what I was doing, I still strained my back. I knew it the second I did it. I felt that pain. That pain I was once very familar with. Now thank God it was not pain the shot down my leg. Thats Disc, you need surgery pain. This was muscle tighting and screaming at me pain. So I took the stretcher outside and paced. And this is where we came in "Are you fucking kidding me?" So I called my supervisor and Safety officer. And went in to get seen by the county doc. I'm getting better the Flexaril has helped ALOT, which is a very good sign. That means its muscle, not disc or nerve. So I get a couple days off rest the old back. I have the spine of a 60 year old. So I sit and I rest and I enjoy the drugs. Until monday when I go back to the Doc and hopefully get cleared to go back to work.

We rock.

2008-01-26T23:42:00.000-05:00

I was a good little paramedic today. Actually, make that a damn good paramedic today. I saved a life. Yep, my friends, I, The Angel o' Death, saved one. Really and truly saved 'em. I pulled some great paramedic magic outta my ass and brought one back. So here's the story. Got called to a chest pain. Pt was sitting up, Talking, CAOx3. Looked fine, skin pink, warm and dry (we are all about skin condition). Tachy at 140s was our guesstimation. not working hard to breath, lungs clear, BP at 130/88. Got [the pt] out to the truck put [pt] on the 12 lead EKG (was c/o of CP pain earlier, now only generalized weakness). The EKG showed....VTach. The pt was so very stable, had a great blood pressure, no SOB, and was still sitting up talking. So I moved the 12 Lead stickers and started putting the defibrillator pads on [the pt] And started explaining that the heart was doing some funky things and that we are doing everything, but its going to be alot of stuff all at once....and that we might have to shock [pt]. I was gonna try to aviod the whole shocking thing and go with anti-arrythmics, but Versed and Cardioversion could work too. anyways... My partner starts working on an IV line and I hop over to the O2 cabinet to get a non-rebreather mask on [pt] As I'm doing that I'm also getting the hospital on the radio to let them know we are coming with a very stable but very much in VTach pt that I'm about to give Amniodarone to. Because at this point with [the pt] as stable as [pt] is, cardioversion is not first line. Until [the pt] looks at my partner and goes "I'm going to go unconscious" to which my partner responds "Are you really now?" Just as the pt flutters and in fact goes unresponsive. To which we both look up and see that [the pt] is now in V Fib. I now throw the radio mic down, mid sentance, grabed a BVM, threw that to my partner and then leaped over the pt, landing on the bench seat next to the monitor. I hit the charge button, looked up, CLEAR! and lit em' up. and then quietly prayed....please don't go into Asystole please don't go into asystole please don't go into asystole. Not Asystole...don;t know what it was...strange looking rhythm, but not asystole. [The pt] then opens eyes looks up and goes "I blacked out there for a second" Ah, no... darling you just DIED there for a second. But we saved you. The rest of the ride was uneventful. No more shocks, no more "I'm going unresponsive"s I made sure of it. [Pt] closed eyes for a second and I yelled, "Don't you be closing your eyes, you keep talking to me [M.P]!" Oh and hile all this is going on, I had forgtton all about the hospital I had on the radio, so I kept hearing "Last unit...advise...Last unit?" Sorry, Miracle Hospital, we were busy shocking our pt back to life. We got 'em back we are stable again. Here's what we have. ETA's less than 5mins. Any more questions/ orders?

So we rock today. My first day back after an 11 day vacation and my first call had to do actual paramedic work. Thinking like a real paramedic is hard. I love my job. I saved someone. We so rock.

Chaos and assholes

2008-01-03T08:38:00.000-05:00

Do ER Docs go to special classes to learn how to be pricks to the medics? I think some do. I think some forget what we have to work with on the streets. I think some forget that we are not glorified taxi drivers and most important I think some forget that not all of us are paragod idiots. Some of us do in fact know what we are doing. I am in fact a good medic, despite my faults (I can't add and I can come off as a dingbat sometimes) but I am, so I've been told, a good medic. I have even been told by a seasoned ER nurse who I have known for a very long time and love and respect that I am a VERY good medic. So when I have an asshole doc tell me during a hectic call over the radio in a very condecending tone "Did you think to give your unconscious, only breathing 4 times a min Pt that you're are assisting ventalations with a BVM with Narcan?" It makes me want to be a total smart-ass back. Which I kinda was. My response was "I would be glad to give my unconscious only breathing 4 times a min Pt Narcan, do you have any other obvoious orders for me Doc? I am 3 mins away from you guys I was trying to encode you before we got there since I am assisting ventilations, We actually just got the line" ASS.

What these ER docs Have to remember is this...I am working in a 4x6 closet on wheels with an EMT Basic who may be a very good Basic, but they can only do BLS. Meaning no Lines, no drugs, no intubations. Thats all on me and me alone. And I may have Fire too...but again...BLS...If I'm lucky I might have another Medic, but usually just one. So One more pair of ALS hands so four ALS hands. I'm doing the same job that the ER doc is doing with several veteran RNs, a respiratory thereapist, an ER tech or two, maybe a resident, a PA maybe all in a cloest with deisel engine. Going down the road at 60 MPH. Do you know how hard it is to hear lung sounds with a crappy stethescope with a siren going and a turbo desiel going at the same time? It's tough. I have even had a ER doc tell me "I don't know how you people get anything done in the back of those things." I just laughed and said "That's why you're a doctor and I'm the kick ass paramedic"
"That you are my dear, you fixed the Patient, now can you take him back to the shelter?"
"Nope, I am 911, strickly one way babe, he belongs to you now"
That happened to be one of the ER docs I like. One who understands what we do. What truly goes on in the back of a truck. That is really is oranized chaos.

On Rope.

2007-12-17T22:35:00.000-05:00

I am now a Level I Rope Technician. Hells Yeah!. So Below are a few photos from our Technical rescue class we had this weekend. A Three day intense as hell class which ended with the building of not one but two massive Highlines over the harbour. we made Anchor points out of nothing in mid air. We did change-overs and pick-offs. We made all kinds of cool shit that my brain can't even wrap itself around right now. But it is the coolest thing I have ever done is to ride a high lie 100 feet in the air. If any of you fire, medical people ever have a chance to take the OnRope courses (www.onrope.com) Fucking do it. It is AMAZING. and you will leave knowing things you never though you would ever understand. I had my AhHa! moments in this class.

Thumbs Up!

2007-12-17T22:34:00.005-05:00

Thumbs Up!
Originally uploaded by artist in the ambulance 190.

The Whole Shebang

2007-12-17T22:34:00.003-05:00

The Whole Shebang
Originally uploaded by artist in the ambulance 190.

Building the Anchor

2007-12-17T22:34:00.001-05:00

Building the Anchor
Originally uploaded by artist in the ambulance 190.

I made a city Yall

2007-12-15T22:11:00.000-05:00

http://truluc.myminicity.com/">truluc.myminicity.com/indtruluc.myminicity.com/ind">

Kinda Cool. Not quite sure what to do now...

Holy Crap, I actually saved one.

2007-12-09T07:38:00.000-05:00

The Angel of Death saved a life. Yep. I know hard to believe but I did. Converted them right outta SVT (SupraVentricular Tachycardia AKA really fucking fast heart rate) with a little prayin' and a little drug I like to call "this is gonna make you feel reeeeeal funny" or Adenosine. Now Adenosine basicly is a drug that stops the heart, causing it to reset and start back up at a normal rate, the patient can have anywhere from a few slow ectopic beats to a period of asystole (flatline). It causes the paramedic to have a breif period of "Oh shit don't stay in Asystole". which they normaly don't, but given my track record, I wasn't taking any chances, I had the difib pads ready, the intubation kit out and fire department on the way. None of which I needed, but like I said, wasn;t taking any chances. So this is how it started. Got called to Chest pain on a young patient. now young CPs are normally bullshit...or crack induced, so when we go the address my partner and I were taking bets on whether it was anxeity or crack. Pull up to this trailer, go inside young pt sitting on sofa, CAOx3, looks fine, complaing of chest tightness. I grab the pt wrist to get a quick pulse, but it was a kind of half-assed gesture so I didn't think much when I didn't feel anything. They was about four other people in the room and I didn;t know if [the pt] knew any of them closly so I didn;t want to go over [pt's] whold medical HX in the house. Pt looks fine so we ambulate to the truck. I sit pt on the stretcher and start with the questions as I put the monitor on [pt] and get the 12 lead cables out. Still haven't looked up at the screen yet. The blood pressure beeps that its done cooking and I then look up. and Holy fuckballs [Pt's] heart is just tachying along at 212. Pretty little narrow complexes. Well I know why your chest hurt darling and why I couldn't feel a radial you got a pressue of 80. Lets just lay back and put so oxygen on you. My Partner god love him got a line for me, the only one he could, a 22 gauge IV in the right wrist. Not the best but it was gonna have to work. Which is where the prayin came into play. So I hit her with the 6mg. Which everyone knows 6mgs of Adenosine never works. Then I hit her with the 12mgs. Which worked goddamnit. Even through a 22g in the wrist. I had never given Adenosine before. I have been there to see it work. Be never been the one to push it. And it worked. I fixed her. I saved her. I'm a pretty good medic.

Okay People...Here's a Medical Lesson

2007-12-02T16:47:00.000-05:00

A few days ago a local news crew did a story on a local County EMS system on bad response times and high employment turnover. The story, while had some vaild points, was for the most part, and for lack of a better term, Bullshit. And while I have lots to say about all of that today I'm gonna talk about something that one woman they interveiwed said that made me want to shoot my own television. Her daughter had dislocated her shoulder, which , from what I understand, she has done many times before. While I understand this injury is very painful. It is not life threating. It blows the big one. And I am very generous with pain medication for my patients show that dislocated or broken a bone. But will you die, not likely, unless you have massive multi-system trauma like bliteral femur fractures and a broken pelvis. Then we start to worry. Anyways, Im getting off track...So Mom's being interveiwed...blah...blah...we waited three days for an ambulance to show up...blah...Then she said it...a statement all Paramedics cringe at..."She could have gone into SHOCK!" What the fuck!...Come again...So here it is a lesson on what is and isn't SHOCK.

Shock is defined in most if not all medical textbooks as: A state of inadequate tissue perfusion. Now there are several types of shock.

Hypovolemic: a reduction in cardiovasular volume AKA bleeding to death or Plasma loss such as the case with Severe burns or Fluid and electrolye loss from massive vomiting/diarrhea.

Distributive: Shock that results from mechinisms that prevent the distribution of nurtients and removal of waste products. The blood and other fluids can't get were they are going due to either poor vascular tone or other reasons such as infection
Anaphylactic: A severe...SEVERE alleric reaction that results in the bloodvessels dilating and movement of fluid in to the interstial space AKA the vessels a too big and fluids are going where they don't need to be.
Septic: Massive Infection were toxins crompromise the vascular's systems' abilty to control blood vessels and distribute blood. AKA the blood vessals are to sick to work right so blood can't get were it needs to be

Obstructive: shock resulted from interference with the blood flowing through the cardiovasular system. AKA...Something plugging up the pipes and/or the pump

Cardiogenic: shock resulting from failure to maintain blodd pressure due to inadequate cardiac output AKA they be having the BIG ONE causing the heart to fail therefore it's not able to pump blood through the body

Neurogenic: shock resulting from an interuption in the communication pathway between the central nervous system and the rest of the body resulting in decrease peripheral vascular resistance. AKA spinal cord injury...brain can't talk to the rest of the body so it can't control the blood vessels below the injury. so they dialte resulting in shock.

Okay thats the types of shock...and they are all bad. If you are in shock you are DYING. Let me repeat that IF YOU ARE IN SHOCK YOU ARE DYING. Shock does NOT happen in the following circumstances: Dislocated shoulder alone, minor MVA in the drive thru of micky d's, during a posticatal state of a ETOH induced seizure, a fall from standing height with no injury, being placed under arrest for DUI/ public drunkeness/ or beating your wife with a chair leg, being filled with the holy spirit, being assaulted by another drunk asshole and the only injury you have is a busted lip. I could go on, but I think you get the picture.

These are examples of shock...Auto-pededestrian with massive facial trauma, large avulsion across left side of chest and amputated arm with a blood pressue of shit over squat. Man with tombstoming ST elevations in fucking every lead with a blood pressure of shit over squat. Female with 8 GSWs to the chest, legs, and Abdomen who is remarkably still alive when police clear the scene for us to come in with a blood pressure of shit over squat. Old guy with a temp of 105, Respiratory rate of 40, heart rate of 140 and pnemonia with blood pressure of shit over squat. These are all shock. So for fuck sake people quit using this word to descibe...well I'm not quite sure what you are trying to descibe. But unless the person is in an ACTUAL state of shock as explained above, just fine some other word to use. And it ain't shock.

People Suck.

2007-11-25T08:09:00.001-05:00

Wow, the Delta Bravos were out in full force last night. But god bless the City Cops, for they kept me sane. One Delta in particular I wanted to assault myself. He gave me the Hold On a Minute Finger...then said "You...Can JUST WAIT a DAMN minute." Uh...No, I can't, you my friend can walk your happy ass to my truck so I can get a better look at the laceration above your eye. I looked at the cop that was standing there who told the guy "Um I would go with her...so she can check you out, plus she alot nicer than us" The guy then proceeded to not give us any of his personal information like medical history or allergies or home address because "he didn't think we needed that" So I kicked him out of the back of my ambulance told his sister that he needed stitches and then stormed over to one of the cops I knew who immediatlly went "B...B...breath..."

"Fuck breathing, J...I'm gonna kick that kid's ass myself. You know you come to assaults going Man I feel sorry for him he just got his ass kicked, then you talk to em and go...I would have kicked his ass too. Fucking Delta. He can bite my ass. His sister's taking him, he's not going in the back of my rig"

And thats the kind of patients we had all night. Fucking assholes. All night, just wanted to be assholes to the paramedics. And I'm a Kind person. Even the cops were like, what the hell? You were nice at the beginning of the shift. I was but you get beat down and by the end you are like all you people suck.

Are you !@#$ing kidding me!

2007-11-11T07:43:00.000-05:00

I sometime wish my internal censor button was just a little less sensitive. I had a a patient last night I just wanted to go "Are you fucking kidding me!?, FUCKING SERIOUSLY!, You are calling me at 0430 for this! REALLY? You do understand you are putting an ambulance out of service for 30 minutes for your fucking superficial laceration...no...wait...abrasion... on the side of you leg that you got...what... three days ago from falling up the stairs thats not even bleeding... What do you want me an EMERGENCY MEDICAL TECHNICIAN to fucking do about it...tonight...right bloody now!? FUCK!... I am not...I repeat...NOT...louder please...NOT! taking you to the Emergency Room. At all...not tonight...or ever. Quit smoking crack. Have a nice night and thanking for choosing us for your health care needs.

And people wonder why our response times are extended sometime. It's because we are dealing with bullshit like this. And when a real emergency drops like YOUR grandmother is having Shortness or your father is having a heart attack the next nearest truck is 20- 30 minutes away.

Also, think about this people who aren't EMS, Police and Fire...When you see an Emergency vehicle driving down the road, with lights flashing and sirens blaring... slow down and MOVE TO THE RIGHT. Don't get pissed. Don't flip us off. Don't honk at us. Don't think we are getting in your way, you are getting in ours. You are just slowing us down and we could be going to YOUR family member. Don't be that Asshole. Really. Just don't.

Didn't Break Nothing this Year

2007-11-03T07:22:00.000-04:00

Regular Readers of my blog may recall this time last year I was layed up in a hospital with my left foot propped up secondary to an unfortunate run in with a flight of stairs after several bottles of wine and all while wear fishnets and 3 inch heels. Well, this years birthday had no such run ins, infact no bottles of wine and no fishnets. For I was working. I spent the night picking up drunk assaults and psych patients from my fair coastal city. The doc that was working the night of my "accident" was working tonight also. She was happy to see my sober and using both of my feet. All night I was asked "Why didn't you take the night off?" Well, my friends there are two answers to that question. One of them is the paragraph above. I didn't want a repeat of last year's hospitals stay. I can find much less painful ways of scoring Dilaudid. And answer number two is this is my weekend off so I got the next three days off, which I'm spending in Asheville, NC. So really, whats another day, honestly? So I worked. I picked up drunks. I saved the sick and the stupid, because thats what I do. I even was there when Lil' Kim was having her 3rd child. She wanted me to call her cousin Beyonce, but her baby daddy didn't like Beyonce, so we thought it better we wait until the baby was born. So that was my birthday night. No broken bones, no hospitals stays by yours truly, no killer staircases. Just a bunch of crazies, drunks, and respiratorys to show for it.

2007-11-01T08:20:00.000-04:00

I signed up on Halloween for drunken debauchery in costumes. What I got was blues hairs falling in the middle of the night and arm tingling. ARE you KIDDING!. Damn it. Oh well there's always next year.

an EMT made me look good

2007-10-26T20:55:00.000-04:00

Ok, we all know the saying Paramedics save lives, EMTs save Paramedics. Well, I always tell my EMT, you job is to make Me, your Parmedic, Look Good. Ok, well my EMT, who I had been having problems with for 4 months, did both on our last shift together. We aren't gonna go into why I had problems with them, thats not the story. The story involves a patient that presented with totally random symptoms that turned out to be a big ol' bad CAT 2. So he we go...

Get called to a "sick party" Now this could be anything, this anything turned out to be inconsolable crying. Really. Pt in a mentally handicapped pt, non verbal, who's family calls this the pt's "pain cry". Pt not eating. HX of bowel obstruction. Fever. Ear infection. Tachy at 130. Hypotensive at 90/60s, but pt is also 80lbs soaking wet. BGL at 200. But Pt is compleatly stable. skin is warm/ dry. Pt will focus on you when you speak. I felt perfectly fine putting this pt in the back with an EMT who is also a paramedic student. But then the family wanted the pt trasported to a hospital who is notorious for asking for an IV for even the most mundane of symptoms and this was a borderline BLS/ALS pt. so I said to my EMT partner "I'll ride this in, but I want you to continue to assess as if this was your pt, do a BGL, put pt on monitor, everything but the IV, oh an get a manual BP the monitor been fucking up" SO he does what I say. and as he put pt on monitor I glance up for my seat as I type my report and I see little Normal sinis complexes marching across the screen. little funning looking, but I'mm get up in a minute when we get going and really look at it when i go the start the IV. from where I'm sitting there's a P wave and an upright QRS so we are golden. I go back to typing. Just then my EMT shoves a strip in my face..."Hey!!B!! is that ST elevation?!?"

"Noooo..Thats just a funny lookin...Well fuck me...
I get up and start flipping through the leads on the monitor and get to Lead I and goddamnit if there ain't huge ST Elevation. Well...get em on the 12 lead...we have elveation in leads I, II, aVL, V2, V3,V4. And BIG elevation. And pt had pressure of 90 and can't swallow, so no Nitro, or aspirin so I just placed em on high flow O2 and high flow disel and off we went. Pt didn't like me neither I had to stick em like 6 time for an IV because {the pt} kept trying to bite me.

That just goes to show you paramedics sometimes need them lowly basics.

So I yelled again.

2007-10-21T09:02:00.000-04:00

People never stop amazing me. I know it's human nature to gawk at an accident scene. To stare at it from the car window as you dive past and imagine the carnage that may or may not be unfolding. To be mezmerized my the flashing lights of the emergency vehicles. To watch as the Paramedics, Firefighers and Police Officers run around on scene in seemingly aimless patterns, with equiptment and notepads and oxygen tanks and stretchers. To even watch as a helicopter lands in the middle of the highway blocking traffic. I can only imagine what this looks like from the outside looking in. As opposed to being right smack in the middle of it.

So as we pull up to the scene there is a small truck, roof caved in. Looked to have rolled several times. Firefighters at the side two criticals laying in the grass. Another across the highway at the side of a family of three sitting up in the grass, not bleeding. They will be care for in a few minutes. I need to see the two laying supine bleeding all over the place first. Just as we were about to pull up a man with a Nikon around his neck leaps in front of the ambulance and snaps off a few shots. I look up and see where he came from. A goddamn fucking tour bus had stopped in the middle of my fucking accident scene. So not only did I have 5 patients (two of which who were critical) but I had a bus full of fucking tourists snapping pictures. Oh and ONE COP. Who sends ONE COP to a multi car MVA? So ever the professional, I get out of the truck and begin my triage. I go to the first patient. Severe SOB and pain on inspiration, bilat, yet dimin breath sounds, several head Lacs, crushed hand. Place him on High Flow O2, Got a trauma RN on scene to hold Manual CSpine while I go see my next patient. CAT 2, trauma center criteria. Run into some tourist who goes, "You just gonna leave him with that fireman?"
I give the stank eye and go "You gonna tell me how to do my job? Or you gonna move so I can triage all my patients? MOVE!"
Next patient...Partner's got him...Altered Mental, repeating questions, weird looking pupils, neck/back/chest pain. Also CAT 2. CSpine. High Flow 02. Trauma Center Critera. Move him to unit.
GO across highway to triage family...All CAT3 facial pain 2nd to airbag deploy. Can wait on 2nd unit. Firefighter stays with family until 2nd unit arrives.

Thats the run down. Now I walk back over to where my criticals are. Where now ALL the tourists from the bus are now off the bus and all have their cameras out and snapping pictures. I have now had it. This is not a show. This is real life. This is not entertianment. There are two people laying in the grass actually bleeding, actual blood from a actual car accident and these people are treating as if it's an episode of "Grey's Anatomy" So as I walk up, I start yelling. "ANYONE WHO IS NOT PART OF MY ACCIDENT, BACK THE HELL UP AND GET THE HELL OFF MY ACCIDENT SCENE." I then think to myself I'm gonna have to call a supervisor later. I'm gonna get complaints. But right now I don't give a damn. And I got back to my original patient. He looks up at me and says "You tell 'em girl" Then the man with the nikon that jumped in front of the ambulance as we pulled up tried to get up close to me and my patient. "If you don't get that camera out of here...you see that cop over there...I will have him cofiscate that lovely little memory card from you lovely camera because you breaking all kinds of HIPPA laws right now, BACK OFF!" I was pissed. This guy felt he had the right to barge in on the lives of my injured and bleeding patients... and on mine for that matter. But I could fight him off. My patients could not. They lay there exposed to the world, both physically and emotionally. So I was angry and I expressed it and not just at this one man, but at the whole bus load of people who treated the whole thing as entertainment. So what if I end up with several tourist complaints in my file. They acted more inapproriatly than I did.
And so we load both our critcals in the back of our unit and too off.

Our patients made it to the trauma center alive and in one peice. And I only pissed off a bus load of tourists. Welcome to our fair city.

phew glads thats over

2007-10-18T07:28:00.001-04:00

Holy mother of god I'm tired. 48 hours on an ambulance will do that to a person. 48 hours and 22 calls later and suprisingly an Angel of Death, such as myself didn't kill any one. (Refer back to a an earlier post for how I earned that nickname) In fact, I might have very well saved one. Woman having the tingling of an Inferior MI. Just the beginings, ever so slight ST elevations in the right Leads (which are ??? my Paramedic students out there) Bradycardic and slightly hypotensive. II did have to laugh at myslef for just a second as I go "I gonna give you a spray of...wait no I'm NOT going to give you nitro, I'm going to turn you fluids up a bit more my hypotensive friend" Its so ingrained, so banged into our heads that EVERY CHEST PAIN GETS NITRO that sometimes we forget that not ALL chest pain pts should get a spray of Nitro.

I do also forget how much fun it is working when you work with someone you get along with and work well together. My partner last night, we have very diffrent styles. Very diffrent. Both of us are laid back type of medics, but I tend to be, well... very sweetly southern. He's from a whole diffrent side of the country and well isn't. He's a no bullshit do you want to do the fucking hospital get in the truck now lets go quit bleeding on my fucking boots type A, but in a way that you like. He lets me be sweet, all while pushing them out to the truck. So it works. Its gets the job done. I get to be sweet and he well...covers me when the shit hits the fan. Plus, he's a good medic with strong medicine. And doesn't look at me funny when I yell at the crackheads who complain of chest pain at 4am (QUIT FUCKING SMOKING CRACK AND YOUR CHEST WILL QUIT HURTING DUMBASS!)

But now I'm going to bed. Sleep is good. And then The Shins concert. I love The Shins. The make me happy.

Keeper of Keys

2007-10-09T22:06:00.000-04:00

Back to nights I go. Its time for our 6 month switch, and I get my nights back. Thank god. I'm getting frustrated on these 24 hour shifts. I'm getting downright mean. Not to my patients, but to my partners. I did have a difficult partner this time around, which is why I haven't been writing as much as I used to. I am afraid of what I might type and to be quite honset I haven't been enjoying the job enough to really write. The frustration had taken over and made it difficult to find the interest to sit in front of my laptop and tap out a post. I hate the managing part of my new position. Sometimes on my 12 mile bike rides I think of ways to get demoted back down to crew member. The best solution I came up with was to look up porn while on duty. It's not hurting anyone, nobody dies and after a while everybody forgets about it. As long as you don't do it again. and you let you friends in on the secret (I'm not really a dirty girl, I'm just tired of being bitched at at 0130 because I put the patient on 12LPM as opposed to 15LPM via NRB masK, does 3 LPM really make that big a fucking diffrerance really?) Or maybe making out with that cute City officer in the back of the unit while on duty. Again...not hurting anyone, not killing anyone. But still against policy. I just want to come to work, pratice medicine and go home. I don't want to have to worry if my EMT partner is going to try and push Narcan on MY patient if I wasn;t there to stop them or writing evals or having to sit my paramedic crew member down and tell them that this is not how we write our reports here when they have been doing EMS since before I was born. But here I am in charge. Keeper of the keys, overseerer of medic units.

Put my Penis in my Pocket

2007-09-23T08:59:00.000-04:00

I yelled at a fireman yesterday. I went all bitch mode on his ass. But it was for a good reason. I was fighing for my patient. I had a bad call. An MVA on a back road. Car wrapped around a tree the only access I had to my patient... the only part I could even see was a wrist. A wrist with no radial pulse. Now the way the car was crushed, mangled around the tree I knew in the pit of my stomach that the person was no longer of this earth. But there was no way I was going to call someone based on just a pulseless wrist. So I wanted the car off the tree. I wanted access to my patient. And I wanted it ten minutes ago. So when the fireman came up to me and goes "She's dead...you got no pulse in the arm. you calling it now? I need to know now before we start pulling on that car and tree" I went off..."I most certianly am not calling based on a pulseless wrist...GET THAT GODDAMN CAR OFF THAT GODDAMN TREE...I need access to my patient, then we can talk about calling...not sooner" I paced a three foot radius around that car for 25 mins while they cut and pulled and yanked the vehicle off the tree. I do not do well with being inactive, with not helping. I'm a paramedic. I am trained to help. I don't watch very well. So I paced, waiting my turn, every so often going "Capt! You got Any activity from the patient?"
"No Baby, Nothing. But I'm still cutting"
"Thats good Capt, keep cutting!"
Then they got it off the tree. A mangled peice of metal. I got access. I was able to pronounce properly. To put my hands on the patient. To see that there was nothing I could do for her.

I broke down later. I couldn't get to her for almost 30 mins. Then I didn't want to leave her.

My supervisor came by after the call to chat. I needed it. I felt bad for getting all bitchy with the fireman. My supervisor told me that being a female paramedic in charge sometime you have to. You have to "Put your Penis in your pocket and fight like hell for the best of your patient, which you did...now you can go away knowing that you did everything you could for her...even if there is nothing you could do for her"

Lessons learned today
You can't save them all.
sometimes you have to put you penis in you pocket...and be a bitch...if it's best for your patient.

I'm being a very slack medic recently

2007-08-22T22:23:00.000-04:00

So I have been productive in some aspects of my job and so slacking in others. To be quite honest, my day to day responsibilities, like washing the truck and making sure that we have all six tires I'm slacking. Because who really care how many transfer needles there are in the IV tray. All I really care about is if there is plenty of oxygen tanks to get my through a shift and if the narcotics and RSI drugs are safely under lock and key and tucked away in the fridge. Is the CPAP machine sitting on the actionary and the laptop plugged in in the back...then I'm going to go take a nap. Those 15 reports sitting in my EMSpro box can sit for a few more hours. I haven't worn civilan clothes in a month and a half. I haven't put on lipstick and masacara for two. I Pay rent for an aparentment I haven't slept at since I moved in three months ago. So forgive me if I don't count the 4x4s(If I you are grabbing more than say 6 4x4 for one wound, you need something other than a 4x4 I might add) nor I'm I going to polish my boots...so there.

But what I have been productive in is reasearching Versed as an alternative for Ativan for contolling Seizures. I recently got an order of IM versed for a 3 year old Status Seizure. This is an order I cannot follow becausse per our state I cannot giver Versed to Pediatric patients. After the call I spoke to the doc, some RNs and other medics and most will agree that Versed is becoming the drug of choice for seizures management. Works faster, higher serum levels for longer (meaning it's longer lasting) and ICU admissions post arrival to hospital are shorter. So if it works better, lets change it. I wouldn't mind hearing from fellow medics who use Versed as first line...what are your thoughts...are the studies true? or are they just blowing smoke up my ass.

Doh!

2007-08-14T10:52:00.000-04:00

In the immortal words of Homer Simpson, all I have to say for myself is DOH!. Yep that was the statement of the night. we were called to an assault, ended up with a non transport which was good because as we were trying to manuver the ambualnce through the maze of police cars that lined the narrow winding street we made contact. Actually, let me back up a bit. To when I hopped out of the truck and started toward one of the officers to go "Hey lets move either this car or this car a bit either this way or that way so we have room to get by" Now keep in mind there are like 9 crusiers on this street all with the blue lights flashing and a large group of people all around...and no street lights. So our mirrors are useless...we can't see shit. While I'm talking to one officer another is guiding my partner from the front of the unit through the maze. He forgets that we are much bigger than a Crown Vic. Wider. With a very large box. So I turn around just in time to see the back corner of the box crack the headlight of a police car. What's even better is that the cop that was spotting us, that was HIS cruiser. My partner didn't find the humor in it. I, however, thought it was hilarious. I mean if you can't laugh at something like this, what can you laugh at. he guided an ambulance into his own police car. Comeon! That's funny. EMS comedy.

So there we sat for about two hours waiting on the sheriff's office to come to do the traffic report. No big deal. Kept us from running sick and stupid calls for a while. I could use the down time.

What have I told you people about lying to the medics?

2007-08-09T09:24:00.000-04:00

I've been getting these weird calls in the middle of the night. Last shift was the assault that we thought was bullshit drunk guy that turned out to be bleeding internally going into shock guy. This shift was it was running from the cops got tased refused to sit up and talk to us guy, but not because he was that beligerant, but because he had a blood pressure of 70/squat and was tachy at 120. What the hell? He was intermitently responsive. The type of resposive that you had to fuck with all the way to the hospital to keep awake, but as long as you kept fucking with him, giving him a good sternal rub or hollar at him when his O2 sats dropped he came right back up to 100%. I did feel kinda bad when I first got him in the truck and kept yelling at him to talk to me "If you can run from the cops, you can sit up and talk to me, quit fucking around" then his pressure was 70. SON OF A BITCH! "What the fuck did you take?"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
"No really, what the fuck did you take!"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
"How much you been drinking?"
"I ain't been drinking man?"
"yes you have I can smell it, what esle you been doing"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
well knock me over I got a fucking angel in my possesion. So he bought himself a ride to the hospital with bilateral 16 gauge IVs a liter of fluid, some Narcan, and was going to get to meet a bunch of very nice nurses with a very large foley catheter at the ER. I also found out that I am getting very good at sliding in 16 gauges into handcuffed patients. Its a strange angle but it can be done.

With it being so hot here are some tips from your friendly paramedic. Because I don't want to pick your ass up.
1.Stay in the AC
2.Stay in the AC
3.Stay in the AC
There's plenty of Law and Order reruns on to enjoy, there is no reason to go outside in this heat, to run, play tennis, mow the grass or really do a damn thing
4. if you must go outside, you crazy bastards. Drink water. not Budweizer, not PBR, not vodka, WATER. or gatorade is fine too or my personal favorite, Revive VitaminWater.
5. Wear light cothing, both in weight and color. This does inclued the lowcountry favorite of searsucker. I didn't say it had to be flattering.

If you becaome unresponsive, stop sweating and your temp gets above 103 you are offically in need of my assistance. And I will be glad to come and get you but I do reserve the right to fuss at you if you do not follow the simple steps listed above. Because it's your own damn fault.

Balmy nights makes for miserable Medics

2007-08-07T20:48:00.000-04:00

Hot, humid nights brings out two things here in the south. CHF and assaults. It was 93 degrees last night with 110% humidity. The air was also very still, nights like this are more bearable with a sea breeze, but last night there was none. So the sweat just sat on your skin. It made all who worked last night move a little bit slower, almost as if the air was so thick held us back. It also make people more mean I think. We got called to a stabbing. No when we got there, it was not a stabbing, well...it was, but it wasn't. He got cut with a knife and had an avulsion on his finger. Now it didn't raise flags when we saw him and he was all sweaty, we were all sweaty. It didn't raise a flag when he was slightly altered, he reeked of ETOH, it didn't raise flags when he kept saying he was thirsty, it was hot, he reeked of ETOH, and to be honest I was wicked thirsty myself. It even didn't raise flags when the blood pressure on the monitor said his blood pressure was 60/30. That damn thing had read a correct blood pressure all night. But when niether me nor my partner could find a radial pulse nor ausultate a blood pressure for ourselves was when we both looked at each other and then at the cops that were standing outside of the back of the truck and say at the same time "Fucker's actually sick!" I put in a 16 ga IV and threw him on a high flow oxygen my partner gets an 18 ga IV and gets him on the EKG (tachy as hell at 130) and We haul ass to the trauma center. He kept saying he was beat with a board in the abdomen (again no flags raised because ADB was soft, flat, non distended) But sure enough, according to the FAST scan at the Trauma Center he had a large amount of blood in his abdomen. I don't know how it works in some systems, but in mine we can, if they don't meet transport criteria, choose not to transport. The finger injury alone does not meet transport criteria. But the altered sensorium 2nd to what We initally thought was ETOH (which did in fact turn out to be shock) did. So you can say, being drunk saved his life.

The other thing we look fotward to on these balmy nights is CHF. This weather really exacerbates it. We gave over the night, 200 mg of Lasix, CPAPed just about everyone who got into the back of our ambulance, and gave more Nitro that even we of that bitter/ sweet orange nitro smell that all medics should be very familar with. I also went through the supply reqs for the night when I restocked after my last CHFer, and every single sheet listed the same thing Lasix and CPAP circuits. Every single one. Thats was all we did last night. But at least it is easy one you get it under control. It's just CPAP, NTG, and Lasix...CPAP, NTG, and Lasix...lather rinse repeat...

I'm afriad of horses

2007-08-01T07:23:00.000-04:00

I'm afraid of horses. Really afraid of them. I never thought this would be a problem until last night when we had a potentially violent psych patient who was being taken care of by two mounted police officers. As we pull up my partner says to me, "Hey, look B, the horse cops are here. I didn't know they came this far up into the ghetto" Neither did I. I just looked at him and said what I thought to myself was "Okay, you can do this, just get out of the truck." Apparently, it wasn't to myself. "You are afriad of horses?!?"
"Uh..No...Yes...well..."
"Jesus, sit here, I got this"
"No..No. I'm not gonna leave you hanging, I'll be alright. I'm just gonna stand over here behind these other police officers across the street from the big scary animals. I got your back if you need it."

Then my partner and the other officers started cracking up. Glad I could be more entertaining than the crazy person who thought he was God.

Promotion

2007-07-25T21:34:00.000-04:00

Well it's offical now. I am no longer an "acting" crew cheif. I have offically earned my Sargent stripe, whicch means I have gottan a pay raise, my own truck and the ability to say to pateints that don't meet our transport criteria that they can get the hellout of the back of my ambulance because there is no way I'm taken their dumb ass to the hospital for a broken toe. It also means that I have to keep up with the keys to the controled meds (I can barely keep up with my car keys what the hell are they thinking giving my the keys to the narcs), make sure my very sweet, but very green partner doen't get himself killed because he keeps getting out of the truck on the interstate without a traffic vest, and figure out how the hell I am supposed to get the 400lb inablilty to ambulate down from the third floorto my awaiting truck in the driveway. (How did you get up here, you're on the third floor?!? Why didn't you stay on the sofa in the huge open living room right by the front door?) Actually, it's not a bad gig. I learning to like being in charge. As a crew member, you can't really say much. You just take it. But as a crew cheif, if your CM gets out of line, you can take thier radio from them. Only letting them speak on the radio when you tell them they can. And when working with ParaGods, you can put them in their place if need be. Teach them they don;t know everything and when to ask for help is not a sign of weakness or stupidity. It's just smart sometimes.

HAHAHHAAHA!

2007-07-25T19:06:00.000-04:00

This is...well listen...
http://gprime.net/flash.php/llamasong

had to share, welcome to earworm hell

Angel of Death

2007-07-14T08:10:00.000-04:00

Angel of Death. Dr. Death. Double Oh Seven. These are just a few of the names I have earned because of yesterday. You know when you are on your third uniform, you have had a bad shift. When you come home wearing you bunker boots because your work boots are soaked through with blood you have had a bad shift. When the Fire Dept keeps a tally on how many full arrests you have worked you have a had a bad shift. Two full Arrests, One traumatic Arrest (GSW who bleed 2 units of blood all over my boots), and six DOAs (one Nursing home and 5 from a massive 4 vehicle MVA that burned up) is the offical death count. Tweleve calls in 24 hours. The AutoPulse batteries didn't even have a chance to charge back up. The Monitor batteries also didn't have a chance to charge. And of course the AC goes out in the box and of course its 122 degrees in the shade and OF COURSE it was 100% humitiy. Oh and the memory card from the monitor was lost along with my cell phone. Its been a bad day. Fucking Friday the 13th.

But I'm home now, with three days off. I have a big glass of wine. And I'm going to bed.

Babies and Social Work

2007-07-07T22:21:00.000-04:00

So our EMS family got an addition last night. A Baby Girl. Pretty Little thing, (5lbs 9oz) with a pretty name of a southern belle, Grace. Now most day old newborns, I must say are pretty funny looking, all wrinkled and weird shaped heads. But Grace..Little Grace is beautiful. She had a whole paparazzi waiting on her. Kid's gonna have to get used to flash bulbs, being that this paramedic "aunt" is a photographer in her other life.

Today was Social Worker day. I was more of that than a Medic today. No life saving, just getting the gears in motion so that my patients today could get the help they so desperatly need. Terminal Cancer patients shouldn't have to spend the last few months on earth in dirty squalor. Geriatric couples should live out the rest of thier days not having to worry about what to do when they fall down and can't help each other get up because they live alone. So I played Social Worker today. It's time consuming, spending all shift on the phone with the people who help us take care of these particular type of problems.

But, I'm laerning my place in my new role. And these types of calls are some of the most difficult. I can fix Congestive Heart Failure, I can take pain away using Morphine, but these people need more than a paramedic. But we are the ones that start the ball rolling.

Learning Curve

2007-06-30T22:56:00.000-04:00

So this Crew Cheif thing is tough. The whole decision making process is tough. The being in charge part is tough. The working with brand new EMTs is tough. Not that I mind any of the things I have listed, just two weeks without a day off makes for very long shifts. I had a few calls that tested me, like the syncope I went to who done fell out in the middle of the street. When we got her in the back of the unit and hooked up to the monitor, she was in an accelerated Junctional, then her heart just stopped for like 3 seconds, then one complex, the another 3 second pause then converted to just a regular junctional. Mind you she was CAOx3, vitals better than mine, and compleatly pain free. Her only complaint "I'm just dizzy" So we took a ride down to the ER where she never had an episode like that again. I did nothing for the woman other than IV and O2. She was more stable than I, so why fuck with something if it's fine, right? Thats how I justified it. Plus we were litterlly 3 mins from the ER. Had we been further I might have put the TCP pads ON her, you know, just in case Then there was the status seizure who I tried IV lorazapam, line infiltrated and I sat for the rest of the transport trying to figure out how to get the drug out of the vile to give it IM. It was one of those things that you don;t think about until you are sitting there going "I know there is a way to get this out, why didn't I ask my FTO. Damnit" Well, the pt still breathing, and thats what matters, a breathing, circulating patient is just fine. Its when the air quits going in and out and blood stops going round and round do I really worry. From what I understand this man spends most of his life in one long continuous Seizure.

So it's all a learning experience, every call prepares you for the next. We work unsavable full arrests so that when that one savable one comes along we are confident in our treatments. Everyday we learn something new, even if it is something as simple as figuring out how to draw out the lorazapam into a syringe, or something as complex as figuring out a dopamine drip or RSI algorhythm. We practice so that with the next one we can go without pause. Everyday I figure out something else that makes my job easier, makes me even treat with thinking, just doing, and doing it correctly and quickly. Makes it easier to save that one. To be able to go, he's alive because of what I did.

Moving on and moving forward

2007-06-25T22:53:00.000-04:00

It has been a rough week. Well two weeks for me, this was day 14 of a 14 day stretch. But this past week especially bad. Driving past all the Fire Stations, seeing the bouquets, the signs, the letters. It make my choke up every time. I even feel bad calling for Fire for man power, or for a driver. I just want to leave them be to grieve. But alas, life must go on. It must move forward. Their will still be fires, paramedics that need help, and patients and citizens that need them. So we grieve this week and start to move on slowly the next week. We can't be sad forever, we must think, they lived and died doing what they love, what was in thier blood to do. You don;t become a firefighter because the money is good or because you like how you look in the bunker gear. You do it because you are made to do it you bleed fire.

Alright enough about that. I was promoted this week also. They handed me the narc keys and told me to go forth and pretend I know what I'm doing. 80 percent of this job is making educated guesses and making it look good. You could have NO idea what is wrong with you patient, but if you make it look good and keep your cool ( and know when to ask for, or call for, help) nobody will ever know, right? I learned how to deal with a difficult partner on a multi patient, multi trauma, very bad MVA (and patients that don;t speak any english on top of it all). Apparently, you threaten to take away said partner's walkie, as they continuiosly kept screaming on the radio before you (as Crew Cheif) could even get a bairing on how many patients, what Category the are and how many more units you need. (The answer is 3 patients, 2 CAT2, 1 CAT3, and two more units.) The following two day were better, as yesterday I had a very green, but very competent EMT, who is so set on doing the right thing, asks permission to do everything. A nice change from the day before. Not that Im on a power trip or anything, I just need to keep control. It's my scene, it anything happens, it's my fault. I'm the grown up.

Moment of Silence

2007-06-19T05:10:00.000-04:00

Please take a moment today in remeberance of the nine City of Charleston firefighters who lost their lives in the line of duty tonight. Thank you.

Okay...not a Failure

2007-06-17T00:01:00.000-04:00

Okay Okay Okay...I'm not a failure. I passed. I actully passed. They are now putting me in charge of an ambualnce for a shift. And I passed with an 80 freaking 7.5. Who knew? Damnit. I happy I guess, scared outta my mind. What the hell am I supposed to do now? Someones life could very well be in my hands. Oh and I'm moving to 12 hour DAYS. Sunlight makes me melt, I say! My brain can't work when it's light outside. Son of a bitch!. Oh well, I'll take a good partner on a bad truck over a bad partner on a good truck anyday. So this is quick a sweet, but I have to go. I have a 48 hour shift ahead of me.

I'm a Failure

2007-06-13T23:58:00.000-04:00

Well, I did it. I finally took my Acting Crew Cheif test today. And to be quite honest, I probally failed. Not because I'm an idiot, but because the questions were off the wall policies and procedures that I don;t know off the top of my head. I know where to find them if I ever need them, like the 10 contraindications for thrombolic therapy in a acute Myocardial Infarction patient. I personally don't need to know what they are. We don't give tPA in the field here. But I would have to know them by the time I encode the hospital, which gives me plenty of time to look them up in my field guide. Same goes for the pediatric dose for an epinepherine drip in a bradycardic pedi or if and when we are supposed to ever transport a DOA (they ain't getting any deader, so again I would look it up in our field guide, or just call a supervisor and go "Can we transport this DOA?) I know the doses for all the drugs in our RSI protocol (1.5mg/kg for Lidocaine and the Succs. .3mg/kg for the etomidate) I know that we need online med control for Dopamine and our controls. Athough, Ativan we can give up to 4mgs on standing order if the patient is activly Seizing. I know that any patient complaining of Chest pain, regardless what the 12 lead EKG shows, gets Oxygen, Nitro, and Asprin. And possibly Morphine if the Doc will let you. I know that CPAP has to stay on the patient so you don't cause flash edema. I know that D50 in administered in a patent IV line as to not cause necrosis. I do get slightly confused mixing D12.5, but help is just a radio click away really.

I also know the proceduere if we break or lose a vial of Morphine...or if we wreck the truck...or what to do if a monitor, drug/ airway combo bag, 4 nasal canulas, a laryngoscope handle (why just the handle?) and 3 D-tanks of oxygen gets stolen from the back of a unit while on a respiratory call in the ghetto. The answer to all three of those questions is "Call a Supervisor"

But, still as ready as I think I am to be putin charge of a truck, I still have to pass the test. Which I don;t think I did this go 'round. Damnit.

Oyst P R

2007-06-13T23:01:00.001-04:00

Oyst P R
Originally uploaded by artist in the ambulance 190.

Ark Drive In

2007-06-13T23:00:00.001-04:00

Ark Drive In
Originally uploaded by artist in the ambulance 190.

It's too damn hot for me to care

2007-06-10T07:46:00.000-04:00

I didn't relize how long it had been since my last post...So here goes. Alright, so I've been moved YET AGAIN. This time to the opposite end of the county. To a fucking hell hole of a truck. I hate this truck. Its busy, the station's too small for the FD and EMS that live there, it's way to busy in the summer, loud, the people in the area are pretentious snobs, oh and it's fucking busy. We ran call after call after call. And because I'm on the truck for my Acting Crew Cheif training it means that little ol me gets to run all the ALS calls. Which is 90% of the call volume. We had 12 calls yesterday, 10 of which I ran. 9 of which were because it was 112 degrees outside and people think drinking several cans of PBR is a perfectly good and healthy way to stay hydrated while mowing the lawn at noon. Everyone was passing out and had a systolic of 70. Oh and apperently it was also moving day for the whole goddamn county, which people also kept hydrated with Budwiezer. I felt like I was working on the surface of the goddamn sun. I lost 10 lbs just sweating. I was a pretty sight when I got off an hour ago. And the smell, oh my, ripe. But I have since had a shower and am about to go to bed. Fucking people.

Then there was the crazy ass woman who passed out, who hit my partner, who grabbed my ass while yelling at me to "Don't you fuck up my wig! This is my good wig!" The mid sentance passess out only to wake up again and finish her thought. She told me about riding along with the narc team with the local PD. "We busted up some college kids selling dope" Jesus help me.

Well thats all I got, going to sleep. night.

Okay, now I'm just rambling...

2007-05-18T00:09:00.001-04:00

Well, I slayed the monster. The headache/ migraine from the devil himself ended yesterday. No more laying in the dark, moaning. I would like to thank the ER, my primary care MD and dilaudid for the help. I was beginning to think I was never gonna go away. I have had migraines for about 8 years now and that was by far the worst. Mostly because the damn thing would not go away. But anyways on to better news.

I move in two weeks! Yippie! My new home is this awesome old house in downtown. Walking distance from everything. Bars, restaurants, little shops, even the medic station. Which is great now that gas is up to 3 bucks a gallon. It is on the Historic Registry, build around 1801. I'm wondering if it is haunted. My new roommates seem great, laid-back people. And the room is freaking HUGE. Its got 12ft ceilings, windows that go almost floor to ceiling, and a fireplace in the bedroom. Non working mind you, but still a great little design feature. The one and only bad thing I can find is there is no real closet, just a bar in a little indentation in the corner. But that is a small price to pay for an otherwise wicked cool place. I have my boys and their trucks lined up for moving day. I am counting down the days.

Work is pretty slow these days. I'm out on the island. Spend my day sleeping and my nights watching Futurama. I have a chill partner, who is funny as hell. Doesn't get worked up over anything. Which I find makes all the differance when you're out in the middle of nowhere. I worked out on the east end of the county once, also in the middle of nowhere, with a partner who I had absoulutly nothing in common with. And it was in a one room station, with no internet, no where to escape. Now that was a hard six months. But this time, I like the guy I'm working with. We listen to the same music, we will chat about photography (he shoots too), sometimes we drive around our district , stopping at old churches or farms so I can snap off some photographs. He will sit and watch cartoons with me in the morning while we eat our oatmeal...or grits. He tells me about his wife and kids, who from the stories seem to be as much of a trip as he is. So, yeah, I like working out there with him. Plus I can work an ass of overtime, then go out there and sleep off the night in the city.

They are still pushing me to get my Acting Crew Cheif. I'm fighting as much as I can, but it seem to be a losing battle. It's not that I don;t think I can handle the medicine. I can, I am a good medic. It's just I don't want to be in charge. I don't have good managing skills. I find it difficult to sit someone down and tell then why they suck. I also don't deligate very well. I just feel I can do it better myself, than to have to explain something to someone. Or tell someone what to do. I know thats how people learn and all, but I feel I'm just as capable to re-stock the truck as my basic partner can. I hate telling people what to do. I'm just not that kind of bossy. I mean I can tell my friends and family what to do all day long, but a co-worker, a partner, it's just diffrent somehow. Plus, I don't want to have to write evals. I know I'm not perfect, so I don't want to have to point out someone elses flaws. I'm just too nice when it comes to things like that. Even in photography school, when we would do group critiques, I was the Paula Abdul of critiques. Even it the photograph sucked balls, I never could say that. I always said things like "Well, the lighting in nice" So, Im fighting the powers that be. I'm quietly refusing to take my acting test. I will continue to fight it until they either pushed the test into my hands or they threaten me.

The Monster in my Head

2007-05-14T10:51:00.000-04:00

I think I'm dying. Well, maybe not dying. But, close. Since Friday afternoon I have been fighting a migraine. I get them occasionally. I take my Maxalt or my Imitrex, lay down with a cold compress for a few hours and they normally go away. On rare occasions, this doen't work and I make a trip to the local ER where I get a small dose of Dilaudid, that normally knocks them out quickly, never to return. This time however something is painfully wrong. I have taken the Max dose fo my Triptans (300mgs every 24 hours) for three days, Alernating Advil Migraine and Excedrine Migraine every four hours. I have made two trips to the ER, one trip to my Primary Care MD, got two doses of IV Diluadid in the ED and a script for 4mg PO Dilaudid from my Primary and the monster is still raging. The whole right side of my head is ripping open. So here I lay, in the dark, stoned on painkillers wishing for either my head to crack open to relieve the pressure or for the narcs to kick in fully so I can just sleep. Sleep would be good.

Status migrainosus is what it's called. A drug- resistant mirgraine lasting longer than 72 hours. I googled it. A rare species of Migraine who is a particularlly nasty, mean little bastard. The little fucker has caused all kinds of trouble this weekend work-wise, money-wise, health-wise. I had to leave work, forcing somebody in. Which I HATE doing, because it sucks being on the receiving end of that phone call with a Supervisor going, "You have to come back in, someone's called out sick" and it really sucks when that sick person works on an outlying truck, an hour from anywhere, and it's 4 o'clock in the afternoon. Thus, making you drive out there only to be relieved in two and a half hours later. This has also caused all kinds of finacial issues because each ER visit is $150, then $25 for my doctor visit, another $8 for the RX, then $50 more on Thursday when I go see my Neurologist, who will probally give me new abortive and prophylaxtic meds. So even more money because most Migraine abortives are band name only, there is no generic form of Imitrex. And of course, being that I work in the medical field and that I watch way too much "House" I have all these thoughts of "Maybe it's a brain tumor" or "Maybe its a AVM" or "Maybe the kid I took care of a week ago with a fever had bacterial Menigitus" or "Maybe it's a rare African parasite that crawled into my head through my nose while I was sleeping and it is now snacking on my brain" or Maybe it's just a fucking Migraine. But whatever it is, It's not going away. So here I lay, possibly dying from a rare African parasite, who I have now dubbed "Bang Bang" after the way he makes my head feel, missing a TRMT knot-tying class that I need to get into all the rest of my Confined Space and High Angle Rescue Classes from the Fire Academy.

!@#$% You Drug Companies

2007-05-05T11:04:00.000-04:00

Been working my fingers to the bone recently. My normal shift is 36 hours right now. Sounds alot worse than it is though. It ususally goes I work the first 12 on a busy urban truck, run 9-12 calls then I travel almost 40 miles out to the islands run maybe 2 calls in the last 24 hours. So sleep is easy out there. In fact yesterday I ran one call then we made it back to the station where I then slept until almost 2030. So no case of the poor mes. You alsmost feel bad taking the systems money, getting pain to sleep and all. Almost. Then you remember what EMS stands for. Earn Money Sleeping.

Quick change of subject...this is something tah really chaps my ass...

I have Asthma. I take Albuterol. I get two MDIs for 6 bucks. Well... I used to get two MDIs for 6 bucks. I went to get my refill the other day and apparently they changed the canister that the inhalers come in. Changed the propellant or something. My new inhaler was 52 bucks and some change. "52 Dollars?!?" I said the the pharmacist. "52 DOLLARS for ALBUTEROL!?! Are you high? Have you guys been snorting the Vicoden back there or something?" My brand name Migraine meds are even that much. This is for just plain ol Albuterol. I refused to pay it. I still have a puffer thats about half full. I'll suck that thing dry before I pay that much for what should noramlly be a very cheap drug. It's cheap like asprin's cheap. What the hell is this world coming too that I, a hard working American, who works in healthcare, who has great health insureance otherwise, has to pay 52 dollars for what any Medicaid recipiant can get for less than $4. But I digress... Just because Warrick Pharamaceuticals is "going green" with some new fancy propellant, they think they can rape the American people and charge this obscene amount for what is a life-saving drug. This is no Viagra. People who use Albuterol use it because without it their airways tighten up and they could die. It's not like the asthmatics of the world can go "Fuck You Drug Companies, Shove it up your assess HMOs, I just not gonna take it, see how you like them apples!" Because they would be doing it while on a ventilator. And as dramatic as that would be, it's nearly impossible to talk with a tube shoved down your throat. So we can only do one thing and pay 52 dollars for a MDI, or 85 dollars for Verapamil (a cheap Calcuim Channel Blocker used to treat hypertension, among other things, like my migraines) or 120 dollars for 8 pills of Imitrex a month. (yes, That is what they wanted to charge me for my Migraine RX before I paid my annual $100 deductable, which is also insane, but again I digress) It's not fair. I already pay almost 90 dollars a month for health insureance. I pay my deductables and co-pays. Why is it now I being made to dig deeping in my pocket for my medications that I need to survive. Are these drug companies not getting enough of my money.

Girl...what you call your Husband?

2007-04-25T07:14:00.000-04:00

We were busy little things. Running all over the city, picking up people from all walks of life. Okay I lie, it was only one kind of walk, the downtown ghetto pimp walk. We had psychs, we had diabetics, we had diabetic psychs, we had people just making shit up for a ride. And I got hit on twice and one marriage proposal that went a little something like this...
"Girl. What you call your husband?"
"I call him Officer.
"For RRRREAL!"
"Yeah, for real."
"Girl, you tripping. Where's yo ring?"
"Man. It's diamonds and platinum. You think I be wearing it to work? You crazy."

I was actully suprised the man took a gander at my ring finger and the fact he knew which finger to look at. I wear a silver ring on my right hand, he knew to check the left. Even though the drunken haze he was fairly observant. Too bad he couldn't tell me what happened to his wrist. "Man I broke or sumpin." Genuis. Then there was a schizo diabetic who would hollar gibberish at the top of his lungs unless I I spoke to him. Then it was "Yeah darling whatever you want, you gots a purtty smile" The cops loved that. We saw one of the officers later and he kept saying "You gots a purrty smile, what you call your husband?" I call him "Doctor" officer. I told my mom who was working at the ER tonight about my sorted adventures with the city crowd and my marriage proposal she asked what kind of fantasy world did I live in? All in a days work I guess. Man. I love the city trucks, you get to meet all kinds of people. Tonight will be my last scheduled night on a city truck though. I get shipped off the the islands for a break, even though I just got back on the truck and don't need a break. But whatever I go where I'm told.

Sleepy...

2007-04-20T07:39:00.000-04:00

Brutal, fucking brutal. I forgot how bad a 24 hour shift is on 12 hour trucks. (just for those who don't read regularly we have 12 hour shifts in the busier parts of the system, and the norm 24/48 hour shifts in the slower parts) We are so short-handed that we sometime work up to but not exceding 36 hours on the busier 12 hour trucks. (Yes, we do get shipped off to slower outlying trucks to try a get some rest if you are on a 36.) Most of us are used to the long hours of runing and running, but I, my friends, am a bit out of practice. this was my first long shift since comming back to the streets. My body aches, my foot hurts and I am getting ready for bed. One more 12 hour shift tonight, then a long three day weekend that is well deserving. Lckly I have a paramedic partner who can help pick up my slack (We run a ALS on every truck, SInce I am still a crew member I will always have a Paramedic Crew Cheif) Also Luckly, even though it was busy, it was busy with alot od crap calls. Nobody dying, nobody in dire need, Nobody really in need of an ambulance. Just some sick party calls, some ETOH over indulgence, and some non cardiac chest pain. I started IVs because the hospital like them, not because the people were truly dying. I did 12 leads because I was told to, not because anyone was having an active MI, I gave O2, not because anyone was Short, but because it comforted and calmed my patients. I gave Morphine to ease the pain of a very angulated ankle, but it was more out of kindness and comfort, than nesessity. But now, I am going to bed only to get back up in 9 more hours to go and do it all again tonight. But fear not citizens, we are used to it.

Eh...

2007-04-17T07:50:00.000-04:00

Run...Run...Run. Thats what we did all night. We went from assault to assault. To CHF then to Asthma. The more assaults. Man I don't know what was going on but people just felt like beating the crap outts each other last night. Nothing serious, mostly Lacerations that might have needed a few stitches... but still. Alot of ass kicking going on for a Monday night. Everybody seemed to have a case of the Mondays too, I got cussed at twice, swung at once and restrained one guy who tried to eat my fingers off. Crack is seriously wack. Oh and we went to this one house because her Imagianary friend was having shortness of breath. (Yes the same one who's other imagianary friend was stabbed a last week, he must have notof made it) But this time, knowing better, we didn't go hunting for 45 mins like we did last week.

I'm gonna end today by saying my heart goes out to all of the students, faculity and families of VT. I don't know you, but you are in my thoughts today... And to the first responders...You did good work yesterday. Medicine in the streets is hard enough when you don't know the people you are helping. I can only imagine what it must be like to work on fellow classmates, friends.

Blegh! OKAY I get it.

2007-04-15T07:57:00.000-04:00

Learned two very important lessons last night. One of which that should be taught is every paramedic school everwhere. Narcan causes, no matter how slooowww you push it, Exorcist type vomiting. I knew it could cause vomiting because that is listed under side effects in the formulary, but what it should say is May cause vomiting that will put your unit out of service for 45 mins and need a mop and a hose to clean up thats what it should say. I have never seen anything like it. It was one the ceiling. Dripping like some brown alein goo you see in horror space flicks. And the second lesson is if you sit on the ambulance bay for long enough outside of the Level One Trauma Center, bloody stabbing victims pull up in POVs causing you to get yet another clean uniform bloody. I had just taken off the vomit shirt. Damnit. Luckly, it was just a little bit of blood and peroxcide got it out, but still. I also have a deep seeded aversion to feet. It goes back to when I was a brand new ER tech, and not knowing better pulled the socks off a homeless person c/o feet pain. With the sock came off three necrotic toes. Since then I don;t do feet. I'm not gonna touch yours and you're not gonna touch mine. I don't get pedicures and my orthopod thought this was hilarous. (He said I was the only patient's he's ever had that he couldn't do a compleate physical exam on because he thought I would freak out. I told him I wouldn't freak out, but make the exam quick) But We had not one but three patients with necrotic diabetic feet. I made my partner ride them in. I couldn't handle it. I said I would take the next five intoxicated assaulted college kids and/or smelly homeless if he would ride in the feet. Thats how bad my Feet Aversion is. Seriously.

Well lessons learned. Add that to my growing list of "Things Every Paramedic should Remember" Right above, push Lorazapam slow and keep a BVM near by, just in case your patient goes apenic. (Yep, learned that one the hard way too)

First Night

2007-04-06T07:28:00.000-04:00

First night back after 5 months of recovery. Foot held up nicely. Only needed one dose of Aleve to calm the screaming bones, and only limped a couple of times, mostly when we stayed still for longer than 30 min. Took about 10 min to work all the kinks out. Which was well, twice in 12 hours. Had 8 calls and one wild goose chase though an apartment complex looking for what turned out to be an imaganary friend of one of the residents. The voices in her head told her that someone had been stabbed. It took 45 mins of looking for this person before us and PD figured it out that she was basicly talking to herself. Ah the joys of urban EMS. I slowly caught on the the new ways the radios worked (we went to digital 3-4 months ago) and working the AVLs. I figured out very quickly that I need to build my muscles back up when I tried to put the stretcher back into the truck fully loaded with a 300 lb patient. And I also need to clean up my now rusty IV skills so I don't turn my poor patients into a human pin cushion. (I did get one, and he was a tough stick) But everyone was right, it's like driving a car (or riding a bicycle) you don't really forget. You just are out of practice. But... I still felt like a new EMT. I drove a bit, running code once or twice, trying really hard not to throw my partner around the back. All and All an pretty tame night back. Now I'm off to bed so that I can do it all again tonight.

I get to go back I get to go back

2007-04-03T20:27:00.000-04:00

Well thank god. I walked into the doctors office today will all the hope of a kindergardener on the first day of school. Hope that I can go back to the ambulance. So I waited quietly of over an hour in the waiting room. Then was brought back and the nurse said "he's a bit backed up" Really, no way, I thought I was just sitting in that room with all the other patients for no apparent reason. But I kept that thought to myself, because I am a sweet, nice person damnit. SO I waited a bit more in the room and the Doc walked in and before he had even shut the door I go "It's-nice-to-see-you-can-I-go-back-to-the-streets-now? My crackheads need me."
"You want to go back to being a street walking crackhead?"
"Yes Please."
"well you can add that statement to the Words I never thought Id hear my patients say list. Yes, you can go back to being a street walking crackhead"
"Thank You...so this is last time I have to see you ever?"
"yep, unless...when is your next big birthday?
"Well, 30 is in about three years"
I actully will miss the doc, he was one of my favorites. He was kind and had a great sense of humor. And most important right after the whole being a good surgeon, has a wonderful bedside manner. Throughout my whole injury and recovery he spoke TO me never AT me. He explained everything and didn't rely on his residents to carry the workload. When I was in the hospital, he would actully come into the room and explain and answer questions, even if the residents had already come in. It's like he takes the time to get to know who he's cutting on. I think he even came down into the ER before I was addmited and spoke to me, which for an attending to do, is well, unheard of. SO I thank him for being so kind to no only me, but my family. So I will miss my doc. But I hope never to see him again, at least not as a patient.

So Thursday night I go back. Back to the streets I call home. I'll be working the City truck. I think I have even found a new apartment. Downtown apartment, in a huge house. I will have mmy hardwood floors and huge windows and 10 ft ceilings. Just what I asked for. And the people in the house seem cool as hell. So everyone, pray to whatever god your pray to that they find me worthy.

New news

2007-03-30T21:39:00.000-04:00

Okay, it was pointed out to me that it has been too long since I last posted, so here is some news. I go back to the ortho-pod on Tuesday. Who told me at the last appointment "Unless you seriously fuck up your foot between now and then, I will absolutly let you go back to the streets..." er...or something along those lines, he might have not dropped the F-bomb, so I was paraphrasing, whatever. So we are looking at the soon-est Tuesday night going back to work, unless I decide to get plastered again and fall down some more stairs. But I think the key to the whole thing was the heels, and since I won't be wearing them anytime soon, I think I'm safe. I survived the past Irish Holiday without an ER visit, so we can rule out the alcohol right? Anyways, I am looking forward to going back to my nights of reaking havoc upon the streets of my fair southern city. HQ is getting a bit...ah...tedious. My job right now is finding lost PCRs (patient care reports, for those who aren't medical) We went to electronic PCRs about three years ago. And medics are a fast thinking, but dyslexic group of people, so they like to transpose call numbers, addresses, times, dates and anything else. So in turn the programs we use loses reports. So I take a list of "Lost" reports which is about 100 calls (You do it by month) and find all the mixed up numbers and street names and fix them so the system can find them. It's like a giant game of Where's Waldo...and it blows. Except when you find one you have spent most of the day looking for. Which you then have 30 seconds of "I found it! I found it!" and then you just go to the next one on the list.

When I go back, I will also have to be Third Person for a couple of shifts. "Not because I'm a retard" as one of my supervisors put it. But because we have installed new AVLs, have a totally new radio set-up (we went to all digital radios about two months ago) and these new Stryker Stretchers that are electronic. Yes, you hit a button and it raises and lowers all on it's own. And the legs raise when you go to put the thing in the truck. And it works up to 700lbs (or 317 kgs). And they changed a few of the standing orders. So It's kinda llike easing me back into EMS. Then I will be on probation for and extra month or so and then I will be able to get my acting crew cheif.

So thats all my news for now.

Rules of a Night Shifter

2007-03-12T22:09:00.000-04:00

So while I was sitting cubicle hell today, trying to fight off sleep and my ADD by reading the newest issue of JEMS (Journal of Emergency Medical Services) I can across an article by Steve Berry. For those who aren't familar with the man. He is the man behind the I am NOT and ambulance driver cartoons. (www.iamnotanambulancedriver.com) He also writes a column of JEMS. A humor column dealing with some of the lighter things in EMS...and they include the wonderfully twisted humor. This month's column actully caught my eye because he writes about the diffrence between Night shift medics and how we can be a little bit more...ah...rough around the edges. Mostly because we are sleep deprived weirdos who deal with more drunks, more psyhos, more violence than our daylight counterparts. EMS can be a difficult job, and even more when the sun goes down. We, as Steve puts it, "replace [our] pen- lights with the foot long MagLite, donning bullet-proof apparel, and matching garlic necklace, carrying Taser guns with silver-tipped prongs, recharging [our] iPods, and carrying a coffee mug so dee that it warrants a lifeguard when left unattended" He also explains how the attitude of the average EMS worker changes after about midnight. We may not be as sharp looking, sometimes fairly ragged, espaically if you catch us at the tail end of a 36 hour shift. As we know from my other post, I prefer the night. I am the only one in my circle of "medic friends" All the rest prefer working when the sun is out. I tried to explain it to them once, but it was futile. I think it has something to do with my mom being a night RN when she was pregnant with me, and when I was growing up, and when I started this job. It was the time I got the hang with my mom. Even now, if I work the city truck, we sometime go to the ER she works in and chill with them. The other people that work in the ED don;t mind because as long as we are with them, we aren;t out reeking havok and bringing them patients. And sometimes we even bring them donuts or bus-cuits from the 24 hour Hardee's down the skreet. So like like the night.
Steve Berry also mentions that everyone seems a little more laid back post midnight. oh...and he also has a list of rules that he states should be "posted on the ceiling of the ambulance, above the stretcher" They cracked me up, but are so true. Just ask any night medic so here...I will share...These are his words not mine...although I agree with every single one of them. (esp. rule number 2 and rule numbers 8, 9 and 10)
1. It's past midnight and I am not the same kindly medic I was at 8am, so be nice. I have big needles
2. I may need to examine you, but you..."no touchy" the medic
3. Alcohol may turn you into an idiot, but try not to be stupid
4.You are not Immortal. Beware: Ambulances used to be hearses
5.Don't force us to use retraints. We used to work in the rodeo
6. If you drank enough to require my services, it's not beneath your dignity to have me hand you a wastebasket to throw up
7.By law, you are not allowed to smoke in most public places. So what makes you think I am going to let you light up in an oxygen-enclosed closet on wheels
8. Arriving by ambulance to the ED won't necessarily get you faster service. Welcome to Managed Health Care.
9. If you think I'm tough, wait until you meat the ED triage nurse and hospital security guards
10. Maybe I wouldn't have to cut your clothes off if you had worn your seatbelt
11. Life's not fair. Get used to if. If it were there would not be 2 million lawyers in this town
12. Coming in by ambulance is not a "get out of jail free" card
13. To repeat: I am sorry, life is not fair. If it was, I wouldn't have to be here with you at this time and at this place. So, take responsiblity: Will this be cash or charge?
Taken from: "The Lighter Side: What They Don't Tell You in Medic School; When Darkness Falls by Steve Berry (JEMS, March 2007)

So To my fellow vampires...enjoy the night. Because everything looks to bright in the daylight.

Computers suck

2007-03-08T17:48:00.000-05:00

Okay people, So My hard drive crapped out on me. Fuck. So it will be a while until I can post again. Just wanted to let yall know.
****EDIT****

I have been borrowing my sister's laptop. So maybe I spoke to soon. Anyways, the closest place I can get my computer worked on in Savannah, Georgia. You would think a city with an art school, and a libral arts college would have an Authorized Apple Dealer. But...noooo...I have to drive 2 hours away to get my computer looked at everytime it hiccups. Or makes a terrible, horrible, very bad screeching noise that I deduced came from the Hard Drive. So I called AIS computers in Savannah, who I have used before and they are wonderful people, and was told that "Yeah, your Hard Drive is about to kick it, and not in a good way, but run Disk Utility, you know, just in case" So after running the Disk Utility, it told me in big bold red letters "The volume Macintosh HD needs to be repaired" So I guess that means my computer is fucked. But at least it is just the hard drive and it will cost me approx. 220 bones to buy and install a new one. thats 120 for the drive and 100 for labor. I would do it myself, but the only downfall to being a card carrying menber of the Cult of Mac, is that Macs are incredibly hard to fix or upgrade hardware. They aren't quite as customizable after the fact as a PC. Still, not a big enough reason for me to switch. I've seen Vista, I watched it as it gave Mr. Gates the Blue Screen of Death during a keynote speech. So went Mac and never looked back (ha! I made a rhyme...I'm an idiot *sigh*) Now I must go and mourn the death of Mac. I'm wearing all black tomorrow.

EMS! Someone call for us?

2007-03-03T22:03:00.000-05:00

So last night I went out with friends for drinks (no broken bones this time). Some EMSers and a couple not. One of the ones who wasn't in public service is acually trying to get on with a local Police department. It will be a good change for him, I think. But he is coming from a 9-5 desk job into a whole new world. So we (the EMSers) were telling him of stories. Some of the more strange things we run into. Now when I say what I'm about to say, It's not in a bad way, but I don't think he has any ideawhat it's like to do a job like EMS or Police work. Being a cop is more than running after people and shooting things. It, like EMS, has mnay diffrent layers for lack of a better word. As they were telling stories and telling him "you think that's twisted listen to this..." I was brought back to my first day as an EMT-B. Small things bothered me Like it really bothered me to just walk into someone's house without knocking. I was rasied in a very southern household where it was just polite to knock. That seemed very strange to me. I got over it very quickly, but I still feel kinda weird opening a door without first knocking. I have learned that it's okay to open the door slightly and yell "EMS! Someone call for us?" And then very quicklt get over what are you gonna see on the other side of the door. Are you gonna see a 80 year old with shortness...or are you gonna find a 400 lbs woman sitting on her sofa buck naked smoking a cigarrette yelling about the Queen of England living in her closet. You just never know.

And as always when one speaks of strange EMS calls the conversation always goes to one place. Things in Orfaces. Eggplants, tabasco sauce bottles, lightbulbs, straight pins, cotton balls, bic pens, you name it, somebody has shoved it up in a deep dark place for various reasons. And you never get a straight story. "I slipped and fell on it". But like any other job, you have to maintain some sort of composure and professionalism. I alway have the same running thought during calls like that ...It embarassing for them....Its embarrassing for them. And I think of something like naming all the Beatles albums in order or mundane things like the recipe for my bean salsa, as to keep me from losing it.

Then there are the heinous scenes, the MVAs with deaths or missing body parts, the homocides, the suicides, the dead baby calls. Too many of those, and one could lose thier mind if they don't know how to approach them. You just go to that happy place in your mind and do your job. You just have to think of it that way. It's my job. It's not easy, but this is what I have choosen to do with my life. You take the good and the funny with the awful and the twisted.
We all have way of dealing with the things that we see. Some go to the shooting range, some run or bike. Some turn to the bottle, whether it be alcohol or pills. I, myslef, shoot photographs or I paint. I go behind the camera and with every click of the shutter I let a little bit of all those fucked up emotions go away. But one thing should be the same for everyone. You need an escape from it. This job can kill a person if you let it. You have to grow a thick skin and an even thicker psyche.

Gerber Daisy Sepia I

2007-03-01T23:57:00.001-05:00

Gerber Daisy Sepia I
Originally uploaded by artist in the ambulance 190.

Gerber Daisy VI

2007-03-01T23:54:00.001-05:00

Gerber Daisy VI
Originally uploaded by artist in the ambulance 190.

Gerber Daisy sepia III

2007-03-01T23:51:00.001-05:00

Gerber Daisy sepia III
Originally uploaded by artist in the ambulance 190.

My very good friend K. sent my flowers the other day. Gerber Daisies, which are my favorites. I was having a cruddy day. But she helped make it so much better. It was kinda funny, I had this big bunch of flowers on my desk all day. And everyone who asked who sent them my reply was "A friend" and why they would ask next " Just because"

They really should have naptime

2007-02-28T00:35:00.000-05:00

I'm reverting back to my old habits a little bit too soon. I was doing really well going to be at a resonable hour back in January, but now...now my bedtime is getting later and later. I think my body's trying to tell me something. Like maybe I just can't operate in a 9-5 world. We all know by now, I am a night shifter. I prefer the dark as opposed to the sun. I have very fair irish skin, what can I say, the sun burns. It was something ingrained in me as a zygote. My mother worked nights when she was pregnant with me, so I think it totally screwed up my circadian rhythm for the rest of my existance. I'm going to blame her. But I don't mind except at 0830 when I have to try and function and not fall asleep at my desk. And I am working on the always exciting bill codes. Isf they would let me I would totlly work 2030 - 0500. My mind works better at those hours, plus there is less distraction in the middle of the night. And if there is something I don't need its any more distraction. The shiny things on the supervisor's desk I sit at provides me with enough of that. Anyways, I am reverting back to the staying up all night...I try and get into bed by 2200, but I tend to lay there staring at the ceiling until I get bored with that and open my laptop back up and internet for the next couple of hours until about 3 when I finally doze off only to be awoken at 7 to get ready for another exciting day in cubicle hell. All the while I'm at work I keep thinking "I wonder if anyone would notice if I crawled uder the desk and took a nap?"

I need...

2007-02-22T23:20:00.000-05:00

I had a friend of mine today say "You're one of the only girls I know that actually misses the work" And I said to myself...I says "Self...Only six more weeks. And then I thought...You spend 8 hours a day 5 days a week in a sunless cubicle, staring at the walls and a computer screen typing in DXs and ICD9s, who wouldn't miss the street?" Right? I need the streets. They are my life. They are a part of me. I feel the need for drips and drugs boluses. I feel the need for blood and guts and Chest Pain and Shortness...I need gunshots and MVAs. I need retarded drunks argueing with me about taking them to the hospital. I need to be able to yell at the stupid DUI kid who just slammed his car into a pole and who has the audacity to call me a bitch. I need precordial thumps, cardioversions, Radid Sequence intubations and needle decompressions. I need to look death in the face and go...HA HA not today you sick bastard! Your not taking him today! I need my old life back. I'm sick of looking at ICD9s and choosing between ALS1 rides and ALS2 rides.

I dream of the day I go back. I miss it. I feel kinda useless. But I am healing. The healer is healing. so I will continue to heal until the day the orthopod says to me "B- you are ready, go forth...save the crackheads; save the sick...save the stupid."

Six

2007-02-21T00:03:00.000-05:00

...Six is the number of the day. I went to my wonderful orthopod today for me post-op exam. The good news is I'm healing quite well despite my best efforts. I'm wearing two mathcing shoes. I do have a slight limp, which is slowing becoming less and less. I have alot of pain at night after being on my feet all day, all of which is normal after... lets count... 5 fractures of my foot. The bad news is he wants me to heal for another Six Weeks!. Six. So April is when I'm looking to hit the streets again. I completly understand his line of thought though. I would rather go back a few weeks late, than go back to early and reinjure my foot. I had a very impresive injury. ( a lisfranc fracture, three metatarsal neck fractures, and a Jones, or Dancers Fracture) But six weeks more in cubicle hell is a long time. I miss my crackheads, my gunshots, my CHFers. But healing is what I'm doing now. He told me if I didn't do what I do, I would be back to work in a week, but because my job intails being on my feet for 12 hours, lifting up to 80 lbs of gear up and down stairs and possibly running for my life when the crackheads start shooting at us, he would rather be safe than sorry. So here I am, six more weeks doing ambulance billing. Which I am happy to do, they didn't have to give me that job. I could just be on LWOP. But still...it kinda sucks. But I'm healing, slowing but steadily.

New post.

2007-02-17T00:53:00.000-05:00

Well, first I'm going to apologize to all of my faithful readers. I am sorry I haven't posted in a while. Been busy, I'm moving this weekend, so between that I being sick, and having my foot cut open to remove the hardware I haven't really been up to posting. But tonight I shall post. Even if it is a completly pointless post.

Well The pin pulling was a success, I am healing quite nicely. It was kinda funny, the anesetheologist who put me under for my first surgery, was also the one who put me under for this procedure. He was going through his shpeal before, "We are going to give you some medicine that will put you to sleep and then we are going to put a breathing tube...blah...blah", when I stoped him and said "I'm a Medic, you can use the big words on me I understand then...so what size tube to you think you will use?..and weren't you the doc that did my nerve block before?" (I'm a 6.5 ETT, just FYI). He then looked at me really hard and then cracked up..."You were the Medic who got tanked on her birthday and shattered your foot weren't you? We still get a kick out of your story. Your fractures were impressive... Yes, that whould be me, I am that girl.

But taody was a big day for me I wore two matching shoes. This is a big deal because for the past three months I have had to wear a big ugly AirCast on the broken foot...but today...TODAY, I wore Both of my Adidas Shelltop Gazelles. Granted one's a little bit more beat up than the other, but nontheless I was still thrilled.

I also pissed off a snarly High School student when I told him that his reason for not wearing a seatbelt was idiotic it is uncomfortable and his brother's, best friend's cousin's life was saved because he WASN'T wearing a seat belt (Thats a really stupid thing to tell a Paramedic who in five years has never cut a dead body from a seatbelt, but has on more than a few occasions scraped dead ejections from the asphalt, because they were not wearing one...it was like when I was told by a HS student from the same HS that drunk drivers are more careful drivers because they are intoxicated, someone explain that logic to me)

Okay, well thats enough for me tonight, I must sleep, tomorrow I have to help test 20 or so EMT's for the 4 open EMT slots for my system. A...A is for Airway...right?

Pin pulling party

2007-02-08T23:11:00.000-05:00

Tomorrow is the day. The day that I have been waiting for for almost three and a half months. Since that fateful fall from grance. No thanks to a bartender and two bottles of a really good spanish wine. I get my screw and last pin removed from my foot. The pin by the way that has almost made it's way to the outside of my skin. gross. But yeah, they come out and I will be able to wear real shoes again. Maybe not black patent leather three inch Steve Maddens, but shoes. I should write a letter the the Madden company though and tell them that even after a fall from three flights of stairs with three shattered metatarsals, a Lisfranc, and a Jones fracture, the shoes remained unscathed. He makes a damn sturdy shoe. Beautiful and tough little things those heels are.

Fallen.

2007-02-03T18:50:00.000-05:00

We had a police funeral today. Not a line of duty death, thank god, but he was a well known and well liked officer, not just by his fellow officers, by other public servants. He was good to us, and he will be missed. I only knew him through work. Would talk on scenes, joke, you know normal stuff. I don't have a whole lot of stories like some of the people who knew him very well. But still...he was one of us.

So I don't know how many of you have even been part of a Police funeral, by it is a sight to behold. The city really does shut down. They closed down the main street in front of the church. All the officers lined up at attention in thier dress blues. We also had about 20 medics lines up behind the officers. Then came the rumble of the motorcycles (the officer was a member of the moto team), officers from every juristiction. The drove in front before the casket, with the officer's police crusier behind them. Then we all filed into the church. After it was over there was a motorcaid that stretched across the Connector in to the Island. Just a line of blue lights that strtched on for ever. We had five units at the end and there was two fire trucks. We wound our way to the grave site. There we fell into line, again behind the officers in the dress blues. They had a bugler that playyed Taps, and bag piper that played Amazing Grace, the 21 gun salute. That even had me choked up. Especially when they handed the folded flag to the Parents. Then came the 10-42 salute. It was impressive and beautiful. You never want to have to see this, but it is a wonderful salute to the type of officer he was.

Stupid people

2007-02-01T23:08:00.000-05:00

Okay well even when I'm not at work I am still witness to the stupidity of humans. SO I was driving home from k's house tonight after Grey's Anatomy... Well actully let me just say this first, It's pouring down very cold rain and it 35 degrees outside...Okay, so...I was driving, sitting at a light on the Crosstown ( a main street that goes from Downtown to the interstate) when I look over to see some totally fratastic dude running down the street in nothing but a show me your vagina Paris Hilton mini skirt. Thats it. Seriously. Thats really all I have tonight. I'm tired and I have to go to cubicle hell in the am.

Sometimes my readers make my day.

2007-01-28T23:37:00.000-05:00

I was looking through some old posts today, reading some comments I never saw because the post are so old and I found this gem of a comment. I love it for last two lines.

Anonymous said...

It's 2 in the morning. I am looking for information on croup. My 3 year old has it bad. Trying to decide if we should go to the hospital. Stuck his head in the ice-box. Kinda helped. He's in bed now calmer but kind of wheezy. Scary, don't like it. His name is Joe. He likes ambulances too.

Those last two lines just made me smile. Kids are wonderful little creatures. I don't know how old this comment is, but I hope Joe feels better. Croup sounds alot worse than it is and smart thinking putting his head in the icebox. A steamy bathroom also works.

so yeah...

2007-01-26T00:31:00.000-05:00

So everyone has their weakness. Even God-like paramedics, like myself (ha!), have something that they just aren't that great at. We are not perfect creatures, especially after a grueling 36 hour shift. I am not on my A game. At about hour 27 I lose all capacity to form real sentances, it mostly becomes a series of grunts and sighs. But thats neither here nor there. My real weakness, Is math. I just can't ever grasp a hold of it, which in my line of work can mean giving a patient Four mgs of Epi instead of point four mg of epi which can result in the patients heart actually exploding. Now, with that said, I do drug calc after drug calc, I carry a calulator in my pocket at all times, along with a whole notepad of doses. I have a chart for all my RSI drugs, I have a chart for all of the drips we carry on the truck, I even have a chart that has all of my pediatric drugs and doses. I have no problem looking things up in my feild guide, my standing orders or whatever esle I have handy. Even if it makes me look a little bit rookie-ish. Because I'd rather look like a rookie to a live patient than a dead one.

The reason I'm telling my secret is that this is why I totally scared to get my Acting Crew Cheif. It's really, really scares me that the powers that be want me...the math retard...to be in charge of a truck. It's not like I can turn to the compleatly green part-time basic and say...So how many drops make 5mcgs per min per kg? Not that I wouldn't trust my Basic, because they can save a paramedics ass. But it's something they don't need to know. It would be like asking the stock boy at the grocery store...so...what should I do about my 401K? The Basic's job is to turn to the overzealous medic who is getting all distracted by all those advanced things like IVs and various tubes and say..."Shouldn't we expose the patient all the way because the cop said the dude heard 4 shots, but I'm only seeing 2 bullet holes? It' might explain why the dudes crashing but the holes we see wouldn't cause that" Yes, we medics have been known to over look the basic stuff because we are so into all that really cool blinky, beeping advanced stuff. But thats another post, so back to me...and my drug problems. You wouldn't think a little thing like a few math problems would have me all worked up like this, but it does. I may be able to read a 12 lead quickly, yet efficently. I may be able to restrain a violent psych in les than 2 minutes. I know that help is only a radio key-up away. But when it's just you and your partner out there, and they have put you in charge of not only you partner, but also some other person's life. And I have to know that you give .5mg every 5 mins up to a dose of .04mg/kg of atropine to the dying bradycardic and also how much fluid goes into that syringe to make .5mgs of atropine. That just scares the hell outta me.

But practice makes perfect. So I will continue to do drug calc after drug calc...drip after drip. Just so when the narc keys are tossed to me on that first shift as an Acting I will be able to quit hyperventalating and be able to help the sick and stupid of my county.